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

Fragkidis, Alexander; Dimitriou, Alexander; Dougenis, Dimitrios

doi:10.1186/1749-8090-7-110

Cited by 9 publications

(12 citation statements)

References 27 publications

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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%

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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Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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“…Reports describing the anesthetic management of postpneumonectomy patients are few; therefore, no official anesthetic guidelines have been set to establish the choice of appropriate anesthetic management, such as the method of anesthesia and its monitoring [ 4 ]. Although the use of laparoscopic surgery has increased, the effect of general anesthesia during the establishment of pneumoperitoneum and that of surgical position on the cardiorespiratory status in postpneumonectomy patients remains unclear [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Utility of the FloTrac™ Sensor for Anesthetic Management of Laparoscopic Surgery in a Patient After Pneumonectomy: A Case Report and Literature Review

et al. 2020

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Patient: Female, 35-year-old Final Diagnosis: Left adrenal gland metastases • post right pneumonectomy for lung metastases • retroperitoneal angiosarcoma Symptoms: Dyspnea Medication: — Clinical Procedure: FloTrac™ sensor Specialty: Anesthesiology Objective: Unusual setting of medical care Background: Pneumonectomy is associated with various anatomical changes and potential complications involving the respiratory and cardiovascular systems. How laparoscopic surgery affects cardiorespiratory status in postpneumonectomy patients is yet to be ascertained. Here, we describe the use of the FloTrac™ sensor for the anesthetic management of laparoscopic adrenalectomy in a postpneumonectomy patient. Case Report: A 35-year-old woman underwent an extended hysterectomy and right pneumonectomy for retroperitoneal angiosarcoma and lung metastases, respectively. The metastasis was found in her left adrenal gland; therefore, laparoscopic adrenalectomy was scheduled. Spirometry demonstrated the following: forced vital capacity (FVC), 1.90 L (55.6% of predicted value); vital capacity, 53.6%; forced expiratory volume (FEV 1 ), 1.38 L (47.3% of predicted value); and FEV 1 /FVC, 72.4%. The heart and mediastinal structures had shifted into the right hemithorax. Hugh-Jones classification was grade 2. The induction of general anesthesia was planned. The patient was orotracheally intubated and managed with the pressure control ventilation-volume guaranteed mode of ventilation, targeting an expired tidal volume of 6–7 ml/kg, without using PEEP. We evaluated cardiac output (CO), cardiac index (CI), stroke volume (SV), and stroke volume variation (SVV) using a FloTrac™ sensor. After the establishment of pneumoperitoneum, SVV increased. CO and SV decreased slightly; however, the patient’s hemodynamic status was stable. After surgery, we extubated the patient in the operating room; she demonstrated good progress and was discharged home on postoperative day 5. Conclusions: We found changes in the values of SVV after pneumoperitoneum in a postpneumonectomy patient. The FloTrac™ sensor may be a minimally invasive and promising monitor for detecting hemodynamic changes associated with laparoscopic surgery in postpneumonectomy patients.

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“…Pneumonectomy can lead to serious physiological, anatomical problems and can cause difficulty for a later open heart surgery. Pulmonary complications related to open heart surgery cannot be easily tolerated in patients with previous pneumonectomy because of limited pulmonary functions and reserves [3,4]. Preoperative pulmonary physiotheraphy and bronchodilator treatment should be done to prepare the patient for postoperative respiratory problems.…”

Section: Introductionmentioning

confidence: 99%

Coronary artery bypass grefting after right pneumonectomy

Kahraman¹,

Yıldırım²,

Öztürk³

et al. 2015

Pau Med J

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A 65-year-old male patient with a 12 year old history of right pneumonectomy was admitted to our cardiology unit with chest pain. The patient was referred to our clinic for CABG surgery when coronary disease of the left main artery was diagnosed with coronary angiography. Pulmonary function tests showed restrictive pulmonary disease and the patient went through respiratory physiotherapy and bronchodilatator treatment for a week before surgery. LIMA and saphenous vein grafts were used during the CABG surgery. A shift in the cardiac structures towards the right hemithorax was observed during surgery. The patient was extubated at the 12th hour after surgery and discharged without any complications on the 8th post operative day.

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

Cited by 9 publications

References 27 publications

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

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

Utility of the FloTrac™ Sensor for Anesthetic Management of Laparoscopic Surgery in a Patient After Pneumonectomy: A Case Report and Literature Review

Coronary artery bypass grefting after right pneumonectomy

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