[Simultaneous off-pump coronary artery bypass surgery and pulmonary resection].
OBJECTIVE
To summarize the experience of combined off-pump coronary artery bypass grafting (OPCAB) and pulmonary resection.


METHODS
Seven patients with unstable angina or a history of myocardial infarction and pulmonary disease underwent combined OPCAB and pulmonary resection. All of them underwent coronary angiography, and neither coronary angioplasty nor stenting was feasible. OPCAB preceded the lung resections. The preferred approach to the heart and lung was by sternotomy. Left upper lobectomy was performed in 2 patients, right upper lobectomy was performed in 1 patient, right lower lobectomy was performed in 1 patient, right upper and middle bilobectomy was performed in 1 patient, left lung volume reduction surgery (LVRS) was performed in 1 patient and bilateral LVRS was performed in 1 patient.


RESULTS
There were no hospital mortality in this group of patients, however there were one late death. Sternal dehiscence occurred in 1 patient which was observed with a need for re-sternotomy and atrial fibrillation was observed in 1 patient. Five patients were diagnosed as malignant tumor by pathology test, and 2 patients were severe chronic obstructive pulmonary disease (COPD). Follow-up ranging from 2 months to 31 months was available for these patients. None of the patients showed evidence of myocardial ischemia after surgery. In one patient, who underwent right upper and middle bilobectomy, local recurrence was found at 19 months after surgery.


CONCLUSIONS
OPCAB carried out simultaneously with lung resection is a safe and effective approach in patients diagnosed with concomitant coronary artery and pulmonary disease. OPCAB may decrease the incidence of postoperative complications.
Qiu
Xue-feng
XF
Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China. qxf027@163.com
Dong
Nian-guo
NG
Pan
Tie-cheng
TC
Wei
Xiang
X
Shi
Jia-wei
JW
D000368:Aged; D000789:Angina, Unstable / Q000150:complications / Q000601:surgery; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008171:Lung Diseases / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D016896:Treatment Outcome