ABSTRACT

PURPOSE:

The concomittance of atherosclerotic cardiac diseases and neoplastic lung diseases is not common. In the past, operation for the cardiac lesion was done first and a second operation had been done for the patology in the lung . Today in suitable patients, concomittant operations are preferred for the patologies in the heart and the lung. In this study, we evaluated retrospectively, the results of the concomittant operations for the heart and lung according to the time of the systemic heparinization.

MATERIAL AND METHOD:

Between January 1995 and June 2002, 9 patients had underwent concomittant CABG and pulmonary resection. 7 patients were male, 2 were female and mean age was 61. Patients with pulmonary lesions had computerized tomography to determine the extend of the lung lesion and evaluate neoplastic metastasis. Median sternotomy was performed in all operations. All pulmonary resections were done before systemic heparinisation, except 2 cases in which resections were done under cardiopulmonary bypass because of the unstable hemodynamy. Resected materials were evaluated via frozen section. 6 patients had wedge resection; others had lobectomy.

RESULTS:

Eight patients were admitted with cardiac complaints. Solitary pulmonary nodules were found at right thorax in 6 patients and at left side in 3 patients. Three patients had malignancy (2 were adeno Carcinoma, 1 was giant cell Carcinoma) and the rest were in benign character. One patient had hilar lymph node metastasis and lymphatic dissection was done during operation. Avarage entubation time was 16±6 hours. Avarage postoperative drainage fluid amount was 760±185ml. The drainage amount was 580±120ml in patients having pulmonary resections before systemic heparinisation and was 1400ml in 2 patients having pulmonary resection under cardiopulmonary bypass. One patient died due to pulmonary distress.

CONCLUSION:

Nowadays, in suitable cases, concomitant coronary bypass and pulmonary resection operations are getting wide acceptance. By this way, the mortality and the morbidity of the second operation will decrease and the time wasted for the second operation of the neoplastic lung disease can be prevented. Performing pulmonary resections before systemic heparinization decreases bleeding insidence and morbidity.