Concomitant Surgical Treatment for Patients with both Coronary Artery Disease and Lung Cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIUHao , WangMing-song , HEYi , YINHang ,  MEIJu

Department of Cardiothoracic Surgery, Xinhua Hospital, School of Medicine of Shanghai Jiaotong University, Shanghai 200082, P. R. China;

Corresponding author：

MEIJu, Email: ju_mei63@126.com

Keywords：

Lung cancer; Coronary artery disease; Coronary artery bypass grafting; Concomitant surgical treatment

DOI：

10.7507/1007-4848.20150032

Video：

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Objective To summarize surgical strategies, early and long-term outcomes of concomitant surgical treatment for patients with both coronary artery disease (CAD) and lung cancer (LC). Methods We retrospectively analyzed clinical data of 15 patients who underwent concomitant surgical treatment for both CAD and LC in Xinhua Hospital, School of Medicine of Shanghai Jiaotong University from January 2006 to January 2014. There were 11 male and 4 female patients with their age of 52-73 years. Preoperative clinical staging of LC was stageⅠtoⅡb (TNM), and postoperative pathological result of most patients (11 patients) was adenocarcinoma. All the patients had normal heart and pulmonary function. All the 15 patients received off-pump coronary artery bypass grafting (OPCAB) via median sternotomy. After OPCAB, 9 patients underwent radical LC resection via median sternotomy, and 6 patients underwent radical LC resection with video-assisted thoracoscopic surgery (VATS). Results There was no in-hospital death or newonset myocardial infarction. Pathological diagnosis included squamous LC in 4 patients and adenocarcinoma in 11 patients. Pathological TNM staging wasⅠb in 4 patients, Ⅱa in 6 patients, andⅡb in 5 patients. Postoperative complications included arrhythmias, atelectasis, and pulmonary infection. All the patients were followed up for 6 months to 5 years. Three patients died during follow-up. None of the patients received redo revascularization or LC resection. Conclusion Concomitant OPCAB and LC resection is a safe and efficacious treatment choice for patients with both CAD and LC.

Citation： LIUHao, WangMing-song, HEYi, YINHang, MEIJu. Concomitant Surgical Treatment for Patients with both Coronary Artery Disease and Lung Cancer. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(2): 114-117. doi: 10.7507/1007-4848.20150032 Copy

1.	Dyszkiewicz W, Jemielity MM, Piwkowski CT, et al. Simultaneous lung resection for cancer and myocardial revascularization without cardiopulmonary bypass (off-pump coronary rtery bypass grafting). Ann Thorac Surg, 2004, 77(3):1023-1027.
2.	Dyszkiewicz W, Jemielity M, Piwkowski C, 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):531-535.
3.	Ciriaco P, Carretta A, Calori G, et al. Lung resection for cancer in patients with coronary arterial disease:analysis of short-term results. Eur J Cardiothorac Surg, 2002, 22(1):35-40.
4.	Serruys PW, Morice MC, Kappetein AP, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med, 2009, 360(10):961-972.
5.	Head SJ, Davierwala PM, Serruys PW, et al. Coronary artery bypass grafting vs. percutaneous coronary intervention for patients with three-vessel disease:final five-year follow-up of the SYNTAX trial. Eur Heart J, 2014 May 21. pii:ehu213.[Epub ahead of print].
6.	Kaluza GL, Joseph J, Lee JR, et al. Catastrophic outcomes of noncardiac surgery soon after coronary stenting. J Am Coll Cardiol, 2000, 35(5):1288-1294.
7.	Marcucci C, Chassot PG, Gardaz JP, et al. Fatal myocardial infarction after lung resection in a patient with prophylactic preoperative coronary stenting. Br J Anaesth, 2004, 92(5):743-747.
8.	Chassot P, Delabays A, Spahn D. Preoperative evaluation of patients with, or at risk of, coronary artery disease undergoing non-cardiac surgery. Br J Anaesth, 2002, 89(5):747-759.
9.	Fernandez FG, Crabtree TD, Liu JX, et al. Incremental risk of prior coronary arterial stents for pulmonary resection. Ann Thorac Surg, 2013, 95(4):1212-1220.
10.	Tourmousoglou CE, Apostolakis E, Dougenis D. Simultaneous occurrence of coronary artery disease and lung cancer:what is the best surgical treatment strategy? Interact Cardiovasc Thorac Surg, 2014, 19(4):673-681.
11.	Inoue M, Okumura M. General thoracic surgery for patients with coronary artery or aortic disease. Kyobu Geka, 2012, 65(8):692-696.
12.	Sabol F, Toporcer T, Kolesár A, et al. Surgical management of a patient with combined heart pathologies and lung cancer. A simultaneous coronary artery bypass surgery, aortic valve replacement, tricuspid valve repair and pulmonary resection. Cor et Vasa, 2014, 56(1):e75-e79.
13.	Cathenis K, Hamerlijnck R, Vermassen F, et al. Concomitant cardiac surgery and pulmonary resection. Acta Chir Belg, 2009, 109(3):306-311.
14.	Zhang Y, Wu Y, Yuan B, et al. Coronary artery bypass grafting with concomitant resection for carcinoma of lung. J Biomed Res, 2010, 24(1):77-80.
15.	Voets AJ, Joesoef KS, Van Teeffelen ME. Synchroneously occurring lung cancer (stages I-II) and coronary artery disease:concomitant versus staged surgical approach. Eur J Cardiothorac Surg, 1997, 12(5):713-717.
16.	Ulicny KJ, Schmelzer V, Flege JJ, et al. Concomitant cardiac and pulmonary operation:the role of cardiopulmonary bypass. Ann Thorac Surg, 1992, 54(2):289-295.
17.	马旭晨, 区颂雷, 张志泰, 等.一期胸腔镜辅助肺癌根治术联合冠状动脉旁路移植的临床应用.中国微创外科杂志, 2013, 13(2):106-109.
18.	Murthy S.Video-assisted thoracoscopic surgery for the treatment of lung cancer. Cleve Clin J Med, 2012, 79(Electronic Suppl 1):es23-25.
19.	Igai H, Yokomise H. Intrapericardial approach via median sternotomy for hilar non-small cell lung cancer invading the main pulmonary artery. Interact Cardiovasc Thorac Surg, 2010, 11(4):385-386.
20.	Hosoba S, Hanaoka Jun, Suzuki T, et al. Early to midterm results of cardiac surgery with concomitant pulmonary resection. Ann Thorac Cardiovasc Surg, 2012, 18(1):8-11.
21.	Zhang R, Wiegmann B, Fischer S, et al. Simultaneous cardiac and lung surgery for incidental solitary pulmonary nodule:learning from the past. Thorac Cardiovasc Surg, 2012, 60(2):150-155.

1. Dyszkiewicz W, Jemielity MM, Piwkowski CT, et al. Simultaneous lung resection for cancer and myocardial revascularization without cardiopulmonary bypass (off-pump coronary rtery bypass grafting). Ann Thorac Surg, 2004, 77(3):1023-1027.
2. Dyszkiewicz W, Jemielity M, Piwkowski C, 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):531-535.
3. Ciriaco P, Carretta A, Calori G, et al. Lung resection for cancer in patients with coronary arterial disease:analysis of short-term results. Eur J Cardiothorac Surg, 2002, 22(1):35-40.
4. Serruys PW, Morice MC, Kappetein AP, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med, 2009, 360(10):961-972.
5. Head SJ, Davierwala PM, Serruys PW, et al. Coronary artery bypass grafting vs. percutaneous coronary intervention for patients with three-vessel disease:final five-year follow-up of the SYNTAX trial. Eur Heart J, 2014 May 21. pii:ehu213.[Epub ahead of print].
6. Kaluza GL, Joseph J, Lee JR, et al. Catastrophic outcomes of noncardiac surgery soon after coronary stenting. J Am Coll Cardiol, 2000, 35(5):1288-1294.
7. Marcucci C, Chassot PG, Gardaz JP, et al. Fatal myocardial infarction after lung resection in a patient with prophylactic preoperative coronary stenting. Br J Anaesth, 2004, 92(5):743-747.
8. Chassot P, Delabays A, Spahn D. Preoperative evaluation of patients with, or at risk of, coronary artery disease undergoing non-cardiac surgery. Br J Anaesth, 2002, 89(5):747-759.
9. Fernandez FG, Crabtree TD, Liu JX, et al. Incremental risk of prior coronary arterial stents for pulmonary resection. Ann Thorac Surg, 2013, 95(4):1212-1220.
10. Tourmousoglou CE, Apostolakis E, Dougenis D. Simultaneous occurrence of coronary artery disease and lung cancer:what is the best surgical treatment strategy? Interact Cardiovasc Thorac Surg, 2014, 19(4):673-681.
11. Inoue M, Okumura M. General thoracic surgery for patients with coronary artery or aortic disease. Kyobu Geka, 2012, 65(8):692-696.
12. Sabol F, Toporcer T, Kolesár A, et al. Surgical management of a patient with combined heart pathologies and lung cancer. A simultaneous coronary artery bypass surgery, aortic valve replacement, tricuspid valve repair and pulmonary resection. Cor et Vasa, 2014, 56(1):e75-e79.
13. Cathenis K, Hamerlijnck R, Vermassen F, et al. Concomitant cardiac surgery and pulmonary resection. Acta Chir Belg, 2009, 109(3):306-311.
14. Zhang Y, Wu Y, Yuan B, et al. Coronary artery bypass grafting with concomitant resection for carcinoma of lung. J Biomed Res, 2010, 24(1):77-80.
15. Voets AJ, Joesoef KS, Van Teeffelen ME. Synchroneously occurring lung cancer (stages I-II) and coronary artery disease:concomitant versus staged surgical approach. Eur J Cardiothorac Surg, 1997, 12(5):713-717.
16. Ulicny KJ, Schmelzer V, Flege JJ, et al. Concomitant cardiac and pulmonary operation:the role of cardiopulmonary bypass. Ann Thorac Surg, 1992, 54(2):289-295.
17. 马旭晨, 区颂雷, 张志泰, 等.一期胸腔镜辅助肺癌根治术联合冠状动脉旁路移植的临床应用.中国微创外科杂志, 2013, 13(2):106-109.
18. Murthy S.Video-assisted thoracoscopic surgery for the treatment of lung cancer. Cleve Clin J Med, 2012, 79(Electronic Suppl 1):es23-25.
19. Igai H, Yokomise H. Intrapericardial approach via median sternotomy for hilar non-small cell lung cancer invading the main pulmonary artery. Interact Cardiovasc Thorac Surg, 2010, 11(4):385-386.
20. Hosoba S, Hanaoka Jun, Suzuki T, et al. Early to midterm results of cardiac surgery with concomitant pulmonary resection. Ann Thorac Cardiovasc Surg, 2012, 18(1):8-11.
21. Zhang R, Wiegmann B, Fischer S, et al. Simultaneous cardiac and lung surgery for incidental solitary pulmonary nodule:learning from the past. Thorac Cardiovasc Surg, 2012, 60(2):150-155.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Concomitant Surgical Treatment for Patients with both Coronary Artery Disease and Lung Cancer

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