title: [Infiltration of Cardiac Vessels by Lung Cancer: Incidence, Classification, Operative Technique with Heart Lung Bypass, and Results].
abstract: Carcinomas of the lung that infiltrate the blood vessels close to the heart (left atrium, pulmonary artery and aorta) without spreading to mediastinal lymph nodes or developing distant metastases are rare overall. Such situations are often classified as primarily inoperable by interdisciplinary tumour boards. This is only the case if, for technical reasons, an experienced thoracic surgeon does not feel able to perform a resection with a surrounding margin of healthy tissue. The surgical strategy to be employed must be chosen individually depending on the infiltrated structure. Complete tumour staging should always be carried out. This also helps in deciding whether neoadjuvant chemotherapy should be given before resection. A heart-lung machine must always be used if larger defects occur due to the resection of blood vessels close to the heart. Using a heart-lung machine in the case of tumour resection does not lead to problems of tumour cell dissemination. Nevertheless, the duration of use of the heart-lung machine should be kept to a minimum, also because of the anticoagulation required. The cardiac defects can be closed securely with the bovine patching materials that are now available. Postoperative morbidity and mortality are low after such resections. Curative resection of blood vessels close to the heart infiltrated by carcinomas of the lung can lead to 5-year survival rates of up to 50 %.
authors.affiliation: Klinik für Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinik Marburg, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Kirschbaum
authors.affiliation: Klinik für Herzchirurgie, Universitätsklinik Marburg, Deutschland.
authors.forename: N
authors.initials: N
authors.lastname: Mirow
mesh_terms: D001018:Aortic Diseases / Q000145:classification / Q000473:pathology / Q000601:surgery; D002315:Cardiopulmonary Bypass; D003331:Coronary Vessels / Q000473:pathology* / Q000601:surgery*; D006325:Heart Atria / Q000473:pathology / Q000601:surgery; D006338:Heart Neoplasms / Q000145:classification / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000145:classification* / Q000473:pathology* / Q000601:surgery*; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000145:classification* / Q000473:pathology*; D011651:Pulmonary Artery / Q000473:pathology / Q000601:surgery; D019043:Vascular Neoplasms / Q000145:classification / Q000473:pathology / Q000556:secondary* / Q000601:surgery*