Cardiac surgery in patients with previous pneumonectomy

Ghotkar, Sanjay V; Aerra, V; Mediratta, Neeraj

doi:10.1186/1749-8090-3-11

Cited by 13 publications

(10 citation statements)

References 17 publications

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“…There have been objections in the past literature concerning the use of the internal thoracic artery (ITA) to perform CABG in previously pneumonectomised patients [ 4 , 19 , 20 ]. For instance, the ITA may be difficult to harvest from the side of pneumonectomy and the pedicled graft may fail to reach its target site due to heart dislocation.…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery bypass grafting and/or valvular surgery in patients with previous pneumonectomy

Fragkidis

Dimitriou

Dougenis

2012

J Cardiothorac Surg

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There is a lack of data regarding heart surgery on patients who have been previously pneumectomized. These patients pose unique challenges and surgical management may necessitate deviations from standard methods in the perioperative course. To summarize the available knowledge and to assess the optimal methods, we reviewed all reported patients with prior pneumonectomy who were subjected to coronary artery bypass grafting and/or valve surgery.In a Medline search from 1966 to May 2011 carefully undertaken, we identified 22 articles, including 29 patients who underwent 30 operations: CABG 70%, valvular surgery 23%, and combination 7%. Severe morbidity was 37% and 30-day mortality 13%.Although postoperative morbidity and mortality remain higher in previously pneumectomized patients undergoing coronary artery bypass grafting and valvular surgery, the gathered experience up to date suggests that a carefully planned surgical strategy, along with the use of advanced modern techniques may reduce morbidity and improve final outcome.

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Section: Discussionmentioning

confidence: 99%

Coronary Artery bypass grafting and/or valvular surgery in patients with previous pneumonectomy

Fragkidis

Dimitriou

Dougenis

2012

J Cardiothorac Surg

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“…The rarity of cardiac surgeries reported in post-pneumonectomy status can be assessed from the fact that only 30 such cases have been reported so far. [34567891011121314] Of these, 24 cases were coronary artery bypass grafting (CABG) and rest were mitral valve replacements/repair and tricuspid repair. Only six cases were done off-pump.…”

Section: Discussionmentioning

confidence: 99%

“…Kinking of left internal mammary artery caused acute left ventricular function in one of the patients requiring cardiac massage. [311]…”

Section: Discussionmentioning

confidence: 99%

Off-pump coronary bypass grafting in a post-pneumonectomy patient: Challenges and management

et al. 2019

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Pulmonary complications are common in cardiac surgical patients. Limited respiratory reserves along with the pain associated with sternotomy add to the morbidity. Patients undergoing cardiac surgery who have had a pneumonectomy done before can be even more challenging to manage perioperatively due to a single-functioning lung. We present a case of a postpneumonectomy patient who underwent off-pump coronary artery bypass grafting. Perioperative optimization of lung function tests was stressed upon including the chest physiotherapy and early mobilization. Preoperative thoracic epidural catheter was inserted for postoperative pain and other proven benefits of thoracic epidural in coronary artery disease patients. We could conclude from our experience that proper optimization of lung function tests and meticulous pain management along with fast-tracking are keys to the management of such patients.

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“…By searching PubMed database, we collected 23 relevant cases from 17 reports since 2001 to 2016 [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21], and summarized surgical approaches and post-surgery complications briefly. There were 5 patients received Aortic Valve Replacement (AVR), 6 patient received Mitral Valve Replacement (MVR) or mitral valve annuloplasty, and 16 patients received CABG (3 patients underwent concomitant surgeries, and 1 patient underwent surgery twice) with previous pneumonectomy.…”

Section: Discussionmentioning

confidence: 99%

Aortic and mitral valve replacement following previous left pneumonectomy: a case report

Fu¹,

Wang²

2018

biomedicalresearch

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Performing double valve replacement in a patient with previous pneumonectomy was challenging. Here, we reported a double valve replacement, which is performed in a 60-year-old female with a history of left pneumonectomy via median sternotomy. Multiple cerebral infarctions were confirmed by cranial computed tomography after surgery with none sequela left, which was suspected causing by air embolism. We review literatures from PubMed and conclude that median sternotomy is still the most common surgical approach. Due to the adhesions induced by previous operation, intraoperative air excluding is important for cardiothoracic surgeons to avoid air embolism after surgery. Post-surgery pulmonary hypertension is also worth paying attention to. Long-term follow-up is necessary to assess the outcomes of surgery.

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Cardiac surgery in patients with previous pneumonectomy

Cited by 13 publications

References 17 publications

Coronary Artery bypass grafting and/or valvular surgery in patients with previous pneumonectomy

Coronary Artery bypass grafting and/or valvular surgery in patients with previous pneumonectomy

Off-pump coronary bypass grafting in a post-pneumonectomy patient: Challenges and management

Aortic and mitral valve replacement following previous left pneumonectomy: a case report

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