Christos Prokakis, Efstratios Koletsis, Efstratios Apostolakis, Nikos Panagopoulos, Nikolaos Charoulis, Dimitrios Velissaris, Kriton Filos, Dimitrios Dougenis
Med Sci Monit 2008; 14(3): CS17-21
Combined heart surgery and lung resection remains a controversial issue. This method facilitates the treatment of two major problems with one intervention, reducing hospitalization cost with acceptable outcomes. On the other hand, skepticism exists related to the effects of cardiopulmonary bypass on malignancy and to a possible greater risk for perioperative bleeding.
Material and Method: A retrospective study is presented of five male patients who underwent combined surgical treatment for heart and lung disease in a one-step procedure between November 2004 and November 2006. Three patients underwent aortic valve replacement with right upper lobectomy. The other two patients underwent pulmonary wedge resection, one combined with coronary bypass and the other with ascending aorta replacement. In all cases, pulmonary resection was performed before cardiopulmonary bypass was established. There was no perioperative death. Three patients had uneventful postoperative recovery, one patient developed atrial fibrillation, and the last one temporary neurological dysfunction. There was no increase in postoperative bleeding or in hospital stay. All patients are under follow-up observation with good performance status. In those patients with pulmonary malignancy, no sign of regional or distant recurrence of the disease is observed.
Conclusions: Combined heart surgery and lung resection can be performed without increased mortality and/or morbidity. The synchronous treatment avoids the necessity of a second intervention with economic benefits and excellent results.
Keywords: Middle Aged, Male, Lung Neoplasms - surgery, Humans, Heart Valve Prosthesis Implantation, Coronary Artery Bypass, Cardiopulmonary Bypass, Carcinoma, Squamous Cell - surgery, Carcinoma, Non-Small-Cell Lung - surgery, Retrospective Studies, Pneumonectomy, Aortic Valve Stenosis - surgery, Aged, Adenocarcinoma - surgery