[A case of concomitant surgery of advanced valvular disease and lung cancer under cardiopulmonary bypass].
We successfully performed a concomitant operation in a patient with severe valvular heart disease with a giant left atrium and a pulmonary cancer. The operation was done via a median sternotomy under cardiopulmonary bypass. The patient was a 62-year-old man with congestive heart failure, NYHA class III. The CT ratio was 76%, and the volume of the left atrium estimated by a CT scan was above 900 ml. An abnormal shadow was recognized in the left upper lung field. Mitral valve replacement with St. Jude Medical valve (31 mm), and tricuspid annuloplasty with a Bex Reducer were performed. After an autonomous cardiac rhythm and a decrease in the size of the left atrium were confirmed, we went on to remove the upper lobe of the left lung under cardiopulmonary bypass. Twelve months postoperatively, the patient was doing well. For a complex case such as the present one, we recommend lobectomy via a median sternotomy using cardiopulmonary bypass as the technique of choice. This method assures good hemodynamic control and provides improved visibility of the pulmonary hilus.
Nakao
M
M
Ogawa
K
K
Asada
T
T
Yamamoto
S
S
Tsuruta
H
H
Tsubota
N
N
D002315:Cardiopulmonary Bypass; D006325:Heart Atria / Q000473:pathology; D006350:Heart Valve Prosthesis; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery*; D008946:Mitral Valve Stenosis / Q000150:complications / Q000601:surgery*; D011013:Pneumonectomy; D014261:Tricuspid Valve; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000601:surgery*