Combined procedures using the extracorporeal circulation and urologic tumor operation--experiences in six cases.
We investigated the question whether combined open heart surgery and urologic tumor operations may be helpful for patients with coincident diseases. From 8/1989 to 8/2000 six patients underwent combined open heart surgery and urologic tumor operation (61-76 years). Two patients suffered from aortic valve stenosis, four patients from ischemic heart disease. Concerning the kidney five patients had an adenocarcinoma, one patient a non-Hodgkin's lymphoma. In two patients we performed an aortic valve replacement and tumor nephrectomy (partial resection of the kidney), respectively. Four patients underwent myocardial revascularization and the corresponding tumor operation. The immediate postoperative course shows satisfactory results. In long-term follow-up one patient reported a low level of loading capacity, however, without typical ischemic symptoms. A clue for a tumor recidivism has not yet been observed. Two patients died 2.5 years after the operation, but the underlying reasons remain speculative because of missing autopsy. Patients suffering from both cardiovascular and kidney disease can be treated in only one setting with low risk. Remembering critically the limited number of cases, we conclude that combined procedures should take preference of operations in two settings, which is in agreement with the current data from the literature.
Department of Thoracic and Cardiovascular Surgery, Heinrich-Heine-University, Moorenstrasse 5, D-40225 Dusseldorf, Germany. litmathe@med.uni-duesseldorf.de
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Litmathe
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Menghesha
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