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Ann Thorac Surg 1990;50:796-799
© 1990 The Society of Thoracic Surgeons

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Articles

Pulmonary resection combined with cardiac operations

Division of Cardiothoracic Surgery, Department of Surgery, State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Buffalo, New York, USA

Accepted for publication July 26, 1990.

^_* Address reprint requests to Dr Canver, Department of Surgery, State University of New York at Buffalo, 100 High St, Buffalo, NY 14203.

Surgical management of patients with concomitant critical cardiac disease and resectable lung lesions is controversial. During a 7-year period (1982 to 1988), 21 patients underwent combined cardiac and pulmonary operations. Patients had cardiac symptoms only; the lung lesions were found on preoperative chest roentgenograms. The pathological diagnosis was established in only 2 of the patients before operation. All underwent concurrent pulmonary resection during cardiac operations requiring extracorporeal circulation. The pulmonary operations included 17 wedge resections and four lobectomies. The final diagnoses in 8 patients with stage I non-small cell lung cancer included epidermoid carcinoma (4), adenocarcinoma (3), and bronchoalveolar carcinoma (1). Postoperatively, 1 patient required a permanent pacemaker and 1 patient died. The actuarial survival at 5 years for all patients who underwent combined procedures was 95%. The 5-year survival for the 8 patients with lung cancer was 88% compared with 100% for those with benign pulmonary pathology (p = 0.172). This experience suggests that combining pulmonary resection with cardiac operations is safe and offers a favorable prognosis to a select group of patients.

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