The early and late results of combined off-pump coronary artery bypass grafting and pulmonary resection in patients with concomitant lung cancer and unstable coronary heart disease☆☆☆

Dyszkiewicz, Wojciech; Jemielity, Marek; Piwkowski, Cezary; Kasprzyk, Mariusz; Perek, Bartłomiej; Gąsiorowski, Łukasz; Kaczmarek, Elżbieta

doi:10.1016/j.ejcts.2008.05.017

Cited by 46 publications

(50 citation statements)

References 17 publications

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“…The advantages are as follows: firstly, if the resected tumor is a bronchioloalveolar carcinoma (BAC), this procedure can be a complete, curative treatment. 5) Secondly, the perioperative risks are fewer than for concomitant lobectomy 1,2) : our result show very few complications, with no empyema, deep sternitis, or prolonged air leakage, possibly due to the safety of using only wedge resection techniques. Thirdly, a second-stage operation can be used to perform a complete radical nodal dissection through a lateral thoracotomy, an operative approach frequently used by general thoracic surgeons, especially for the lower lobes.…”

Section: Discussionmentioning

confidence: 68%

“…There have been few large-scale studies of lung resection with concomitant cardiac surgery, [1][2][3][4] about which there is still no widely accepted consensus. At our institution, we have decided to perform cardiac surgery with concomitant wedge resection.…”

Section: Discussionmentioning

confidence: 99%

“…sequential and concomitant procedures, [1][2][3][4] the choice of which depends on the individual institution. Some institutions conduct a staged surgical procedure in which the cardiac surgery is mostly performed first followed by the lung surgery.…”

mentioning

confidence: 99%

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Early to Midterm Results of Cardiac Surgery with Concomitant Pulmonary Resection

Hosoba

Hanaoka

Suzuki

et al. 2012

ATCS

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Background: We report our experience of cardiac surgery with concomitant pulmonary resection, based on analysis of the results. Methods: Eleven patients (1 woman, 10 men) underwent cardiac surgery simultaneously with pulmonary resection; ten of them through median sternotomy. The cancer pathology consisted of non-small cell carcinoma (n = 10), and benign teratoma (n = 1). All lung lesions were removed using a wedge resection. Cardiac procedures consisted of off-pump coronary artery bypass grafting (n = 4), aortic valve replacement (n = 3), mitral valve plasty (n = 2), total arch replacement (n = 1), and descending aorta replacement (n = 1). Lung wedge resections were performed after induction with protamine sulfate. Results: The mean follow-up period was 19 ± 11 months (2-34). There was no operative mortality and no major cardiac complications. Three patients underwent a subsequent lobectomy through lateral thoracotomy. There were two postoperative deaths: one was from an unknown cause, 8 months postoperatively and another was from a lung cancer recurrence, 9 months after surgery. There were two local recurrences, 9 months and 14 months, postoperatively. The mean cancer-free period was 17 ± 10 (2-32) months. Conclusion: Rates of operative mortality and morbidity following cardiac surgery with concomitant pulmonary resection were favorable, and early to midterm results were acceptable. Keywords: lung cancer, concomitant cardiac surgery, wedge resection Ann Thorac Cardiovasc Surg 2012; 18: 8-11 doi: 10.5761/atcs.oa.11.01717 sequential and concomitant procedures, 1-4) the choice of which depends on the individual institution. Some institutions conduct a staged surgical procedure in which the cardiac surgery is mostly performed first followed by the lung surgery. Potential problems with this approach include delay in the lung resection due to the postoperative recovery phase and the additional cost of two operations. However, the concomitant procedure also has its shortcomings, such as the risk of dissemination due to manipulation of the pulmonary lobe, mechanical stress on the cardiac chambers, inability to perform radical lymph node dissection, and the risk of increasing the amount of blood loss due to the effect of heparinization.We studied a series of eleven patients who underwent concomitant pulmonary wedge resection and cardiac surgery. The aim of the study was to analyze the outcome of

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

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Early to Midterm Results of Cardiac Surgery with Concomitant Pulmonary Resection

Hosoba

Hanaoka

Suzuki

et al. 2012

ATCS

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“…In addition, cardiac surgery using cardiopulmonary bypass generally causes systemic tissue edema, which may increase the risk of failure of gastrointestinal tract anastomoses (13). A recent trend has been the use of off-pump CABG to avoid the effect of cardiopulmonary bypass and decrease the use of heparin (10,14,15). The off-pump technique could markedly lower the risk of the disadvantages related to use of cardiopulmonary bypass, although other studies found no advantage of using an off-pump technique compared with cardiac surgery using cardiopulmonary bypass (3,(13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

“…A recent trend has been the use of off-pump CABG to avoid the effect of cardiopulmonary bypass and decrease the use of heparin (10,14,15). The off-pump technique could markedly lower the risk of the disadvantages related to use of cardiopulmonary bypass, although other studies found no advantage of using an off-pump technique compared with cardiac surgery using cardiopulmonary bypass (3,(13)(14)(15). The present study demonstrated that concomitant OPCAB and non-cardiovascular surgery compared with those of isolated OPCAB did not increase operative mortality and perioperative morbidities, although the majority of patients had concomitant malignant disease and underwent laparotomy (63 patients had combined malignant diseases; 62 patients underwent general surgeries opening the abdominal cavity).…”

Section: Discussionmentioning

confidence: 99%

Concomitant off-pump coronary artery bypass and non-cardiovascular surgery

Han

Choi

et al. 2016

J. Thorac. Dis.

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Background: Reports on concomitant cardiac and non-cardiovascular surgeries have noted disadvantages in the use of extracorporeal circulation. We assessed the results of concomitant off-pump coronary artery bypass (OPCAB) and non-cardiovascular surgery, and compared them with isolated OPCAB results.Methods: Of 2,439 patients who underwent OPCAB between 1999 and 2014, 115 patients underwent concomitant OPCAB and non-cardiovascular surgery. Combined non-cardiovascular diseases included 63 malignant and 52 benign diseases. Concomitant non-cardiovascular surgeries performed were general (n=62), thoracic (n=47), orthopedic (n=3), urologic (n=2) and otolaryngologic surgeries (n=1). Operative results were compared between the OPCAB patients who underwent concomitant non-cardiovascular surgeries (group 1, n=115) and isolated OPCAB patients (group 2, n=2,251). Because preoperative characteristics of the two groups were different, a 1:2 propensity score-matched analysis was performed and operative results of the two matched groups were compared.Results: Operative mortality rates were 0.9% (1/115) in group 1 and 1.0% (22/2,251) in group 2 (P=0.909).Although there were differences in preoperative patient characteristics, postoperative complications, including atrial fibrillation (36.5% vs. 28.8%), perioperative myocardial infarction (MI) (4.3% vs. 5.2%), acute renal failure (1.7% vs. 4.9%), mediastinitis (0.9% vs. 0.8%), bleeding reoperation (0.9% vs. 2.9%), and respiratory complications (2.6% vs. 2.1%), did not show significant differences between the two groups.After a 1:2 propensity score-matched analysis, there were no statistical differences in operative complications between the two groups.Conclusions: Concomitant OPCAB and non-cardiovascular surgeries were not associated with increased mortality and postoperative morbidities when compared with isolated OPCAB.

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Anesthesia for Combined Cardiac and Thoracic Procedures

Wąsowicz

2011

Principles and Practice of Anesthesia for Thoracic Surgery

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The early and late results of combined off-pump coronary artery bypass grafting and pulmonary resection in patients with concomitant lung cancer and unstable coronary heart disease☆☆☆

Cited by 46 publications

References 17 publications

Early to Midterm Results of Cardiac Surgery with Concomitant Pulmonary Resection

Early to Midterm Results of Cardiac Surgery with Concomitant Pulmonary Resection

Concomitant off-pump coronary artery bypass and non-cardiovascular surgery

Anesthesia for Combined Cardiac and Thoracic Procedures

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