Combined off-pump coronary artery bypass surgery and pulmonary resection.
BACKGROUND
Combined cardiac surgery and pulmonary resection using cardiopulmonary bypass (CPB) has been described previously. There are a few reports of combined procedures done without using CPB. Off-pump coronary artery bypass grafting (OPCABG) eliminates organ dysfunction and suppression of immune system related to extracorporeal circulation.


METHODS
Six patients underwent combined OPCABG and lung resection during a 4-year period. Follow-up ranging from 9 months to 3 years is available for these patients.


RESULTS
Malignant pathology was the diagnosis in 5 patients and 1 patient was diagnosed with advanced chronic obstructive pulmonary disease. Right upper lobectomy was performed in 3 patients, left upper lobectomy was performed in 1 patient, right upper and middle bilobectomy was performed in 1 patient, and bilateral lung volume reduction was performed in one patient. Prolonged air leak occurred in 1 patient postoperatively and another patient experienced small right-sided residual pleural space that was resolved at 6 weeks follow-up. There were no operative deaths but there were 2 late deaths. Evidence of recurrence for angina or malignancy upon follow-up was not detected.


CONCLUSIONS
A combined procedure is a safe approach in patients diagnosed with concomitant coronary artery and pulmonary disease. Avoidance of CPB may decrease the incidence of postoperative complications.
Saxena
Pankaj
P
Department of Cardiac Surgery, The Prince Charles Hospital, Rode Road, Chermside, Brisbane 4032, Queensland, Australia. drpankajsaxena@hotmail.com
Tam
Robert K W
RK
D000368:Aged; D002283:Carcinoma, Bronchogenic / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D047549:Coronary Artery Bypass, Off-Pump; D003327:Coronary Disease / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008175:Lung Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods; D011183:Postoperative Complications; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D016896:Treatment Outcome