title: Simultaneous operation for cardiac disease and gastrointestinal malignancy.
abstract: OBJECTIVE
  To investigate the safety of performing simultaneous cardiac surgery and a resection of a gastrointestinal malignancy.
  
  
  METHODS
  Among 3664 elective cardiac operations performed in adults at Kagoshima University Hospital from January 1991 to October 2009, this study reviewed the clinical records of the patients who underwent concomitant cardiac surgery and a gastrointestinal resection. Such simultaneous surgeries were performed in 15 patients between January 1991 and October 2009. The cardiac diseases included 8 cases of coronary artery disease and 7 cases with valvular heart disease. Gastrointestinal malignancies included 11 gastric and 4 colon cancers. Immediate postoperative and long-term outcomes were evaluated.
  
  
  RESULTS
  Postoperative complications occurred in 5 patients (33.3%), including strokes (n = 1), respiratory failure requiring re-intubation (n = 1), hemorrhage (n = 2), hyperbilirubinemia (n = 1) and aspiration pneumonia (n = 1). There was 1 hospital death caused by the development of adult respiratory distress syndrome after postoperative surgical bleeding followed aortic valve replacement plus gastrectomy. There was no cardiovascular event in the patients during the follow-up period. The cumulative survival rate for all patients was 69.2% at 5 years.
  
  
  CONCLUSIONS
  Simultaneous procedures are acceptable for the patients who require surgery for both cardiac diseases and gastrointestinal malignancy. In particular, the combination of a standard cardiac operation, such as coronary artery bypass grafting or an isolated valve replacement and simple gastrointestinal resection, such as gastrectomy or colectomy can therefore be safely performed.
authors.affiliation: Teruo Komokata, Mamoru Kaieda, Takayuki Ueno, Department of Surgery, Kagoshima Medical Center, National Hospital Organization, Kagoshima 892-0853, Japan.
authors.forename: Teruo
authors.initials: T
authors.lastname: Komokata
authors.affiliation: Teruo Komokata, Mamoru Kaieda, Takayuki Ueno, Department of Surgery, Kagoshima Medical Center, National Hospital Organization, Kagoshima 892-0853, Japan.
authors.forename: Mikio
authors.initials: M
authors.lastname: Fukueda
authors.affiliation: Teruo Komokata, Mamoru Kaieda, Takayuki Ueno, Department of Surgery, Kagoshima Medical Center, National Hospital Organization, Kagoshima 892-0853, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Kaieda
authors.affiliation: Teruo Komokata, Mamoru Kaieda, Takayuki Ueno, Department of Surgery, Kagoshima Medical Center, National Hospital Organization, Kagoshima 892-0853, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Ueno
authors.affiliation: Teruo Komokata, Mamoru Kaieda, Takayuki Ueno, Department of Surgery, Kagoshima Medical Center, National Hospital Organization, Kagoshima 892-0853, Japan.
authors.forename: Yoshihumi
authors.initials: Y
authors.lastname: Iguro
authors.affiliation: Teruo Komokata, Mamoru Kaieda, Takayuki Ueno, Department of Surgery, Kagoshima Medical Center, National Hospital Organization, Kagoshima 892-0853, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imoto
authors.affiliation: Teruo Komokata, Mamoru Kaieda, Takayuki Ueno, Department of Surgery, Kagoshima Medical Center, National Hospital Organization, Kagoshima 892-0853, Japan.
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Sakata
keywords: Cardiac disease; Colon cancer; Gastric cancer; Gastrointestinal malignancy; Simultaneous operation