SURGICAL TREATMENT OF CONCOMITANT SEVERE HEART DISEASE AND LUNG CANCER
The concomitant presentation of lung cancer and severe heart disease requiring intervention is a scenario that many clinicians have to face. Its common physiopathological substratum is unknown and it is believed that tobacco plays a role. From a surgical point of view, these patients pose various technical challenges and medical literature is scarce in providing solid answers. The aim of this report is to review our experience with cases undergoing combined surgical treatment of both heart disease and lung cancer, aiming to analyse patients’ characteristics, operative technical considerations and related outcomes. A total of five patients were included, with two synchronous procedures, two cases with lung surgery being performed first and one case commenced with cardiac surgery. All cancers were non-small-cell lung carcinoma or carcinoid tumors and cardiac disease was mostly represented by severe aortic stenosis. Lobectomy was performed in two thirds of patients and minimally invasive techniques were used in 60% of the procedures. All valvular patients received a bioprosthesis. There was one immediate complication, with good recovery on follow-up, and there were no late events (median follow-up of 1,8 ±1,1 months). The analysis of these cases highlights the complex nature of these challenging patients and reinforces the importance of devoting efforts to offer the most suitable solutions for each scenario.
Kanzaki R, Kimura T, Kawamura T, Funaki S, Shintani Y, Minami M, et al. Treatment of simultaneously discovered lung cancer and cardiovascular disease: a 20-year single-institution experience. Surg Today. 2017;47(6):726-32.
Kovacicova K, Omran N, Mandak J. Combined surgical treatment of lung cancer and heart diseases. Bratisl Lek Listy. 2014;115(12):776-80.
Dyszkiewicz W, Jemielity M, Piwkowski C, Kasprzyk M, Perek B, Gasiorowski L, et al. The early and late results of combined off-pump coronary artery bypass grafting and pulmonary resection in patients with concomitant lung cancer and unstable coronary heart disease. Eur J Cardiothorac Surg. 2008;34(3):531-5.
Hosoba S, Hanaoka J, Suzuki T, Takashima N, Kambara A, Matsubayashi K, et al. Early to midterm results of cardiac surgery with concomitant pulmonary resection. Ann Thorac Cardiovasc Surg. 2012;18(1):8-11.
Cathenis K, Hamerlijnck R, Vermassen F, Van Nooten G, Muysoms F. Concomitant cardiac surgery and pulmonary resection. Acta Chir Belg. 2009;109(3):306-11.
Kaku R, Teramoto K, Ishida K, Igarashi T, Hashimoto M, Kitamura S, et al. Simultaneous resection of pulmonary tumor following cardiovascular surgery. Asian J Surg. 2017;40(2):123-8.
Saxena P, Tam RK. Combined off-pump coronary artery bypass surgery and pulmonary resection. Ann Thorac Surg. 2004;78(2):498-501.
Schoenmakers MC, van Boven WJ, van den Bosch J, van Swieten HA. Comparison of on-pump or off-pump coronary artery revascularization with lung resection. Ann Thorac Surg. 2007;84(2):504-9.
How to Cite
This work is licensed under a Creative Commons Attribution 4.0 International License.