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.
Department of Cardiac Surgery, The Prince Charles Hospital, Rode Road, Chermside, Brisbane 4032, Queensland, Australia. drpankajsaxena@hotmail.com
Pankaj
P
Saxena
Robert K W
RK
Tam
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