title: Simultaneous cardiac and lung surgery for incidental solitary pulmonary nodule: learning from the past.
abstract: BACKGROUND
  Incidental solitary pulmonary nodules (ISPN) detected prior to scheduled cardiac surgery are rare but challenging. We evaluated the long-term outcome of patients with ISPN undergoing simultaneous cardiac and lung surgery.
  
  
  METHODS
  The clinical records of 33 consecutive patients with ISPN undergoing cardiac and lung surgery, either simultaneously (n = 30) or sequentially (n = 3), were retrospectively evaluated and completed by detailed follow-up.
  
  
  RESULTS
  On histological examination, 14 cases (42.4%) of primary NSCLC were identified. Benign findings consisted mostly of hamartoma and inflammation. Malignant ISPN were larger in size (22.5 ± 12.4 vs. 13.6 ± 8.6 mm) and ISPN with a diameter >10 mm had a higher incidence of malignancy compared to those ≤10 mm (56.0% vs. 0%). Patients undergoing concomittant heart and lung surgery received either a wedge resection (n = 26) or a lobectomy (n = 4). The 5-year survival of patients with malignant ISPN was lower than that of patients with benign ISPN (43.6% vs. 85.6%).
  
  
  CONCLUSIONS
  Our results corroborate a high incidence of malignancy in ISPN detected prior to scheduled cardiac surgery. Simultaneous cardiac and lung surgery for NSCLC appears to be associated with a poor long-term outcome.
authors: Department of Cardiac, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany. zhang.ruoyu@mh-hannover.de
authors: R
authors: R
authors: Zhang
authors: B
authors: B
authors: Wiegmann
authors: S
authors: S
authors: Fischer
authors: N J
authors: NJ
authors: Dickgreber
authors: C
authors: C
authors: Hagl
authors: M
authors: M
authors: Krüger
authors: A
authors: A
authors: Haverich
authors: P
authors: P
authors: Zardo
mesh_terms: D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D005858:Germany; D006331:Heart Diseases / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006801:Humans; D033162:Incidental Findings; D053208:Kaplan-Meier Estimate; D008171:Lung Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D008175:Lung Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D003074:Solitary Pulmonary Nodule / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome