title: [Management of Patients with Preexisting Cardiac Complications during Thoracic Surgery for Lung Cancer].
abstract: In patients with preoperative cardiac complications such as myocardial ischemia, arrhythmia, or congestive heart failure, it is important to offer any necessary medical treatments, such as anticoagulation therapy, prior to surgery. This study investigated the perioperative results of surgical treatment for primary lung cancer in patients with cardiac complications. Data relating to 467 patients who underwent lung resection for lung cancer between April 2010 and March 2014 were collected. Perioperative factors for patients with preoperative cardiac complications and patients without preoperative cardiac complications were compared. Perioperative factors were also compared for a heparin bridging group and non-heparin bridging group in 53 anti-coagulation therapy patients.
  
  
  RESULTS
  Fifty-three (11.3%) patients had preoperative cardiac complications;the majority of these had ischemic heart disease( n=31, 58.5%), while a significant minority had atrial fibrillation( n=14, 33.3 %). Of these, 42 patients(79.2%)were receiving anti-coagulation therapy;pre-operative bridging anti-coagulation using heparin was performed in 19 patients(45.2%). There were significant differences between those patients with preoperative cardiac complications, and those without preoperative cardiac complications, in terms of sex( male;81.1% vs 65.7%, p=0.024), mean age(73.1±1.0 year vs 68.4±0.7 year, p=0.001), and duration (days) of hospitalization after surgery(10.1±2.4 vs 7.8±2.0, p=0.023). There were significant differences between patients who received pre-operative heparin bridging anticoagulation, compared with those who did not, in terms of age(70.8±1.2 year vs 76.8±0.9 year, p=0.001)and duration (days) of hospitalization after surgery(10.5±2.1 vs 7.5±1.3, p=0.005).
  
  
  CONCLUSIONS
  Fifty-three(11.3%)patients had preoperative cardiac complications. Recent changes in the demographics of surgical candidates, in terms of age, have increased the number of patients with surgical risk factors. Perioperative patient management has become more important than before.
authors.affiliation: Department of Thoracic Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Ishibashi
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Seto
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Okubo
mesh_terms: D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000188:drug therapy*; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008175:Lung Neoplasms / Q000150:complications* / Q000601:surgery*; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications; D011013:Pneumonectomy; D011300:Preoperative Care; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D006493:Heparin