[Surgical results and perioperative complications in patients presenting lung cancer and cardiovascular diseases]
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1Department of Thoracic and Cardiovascular Surgery, Kansai Medical University, Moriguchi, Japan.
Insights
A preoperative assessment for ischemic heart disease (IHD) aids lung cancer surgery management. However, more precise IHD detection methods are needed to prevent perioperative cardiac events in these high-risk patients.
Area of Science:
- Cardiology
- Thoracic Surgery
- Oncology
Context:
- Lung cancer surgery patients often have co-existing cardiovascular disease, particularly ischemic heart disease (IHD).
- Preoperative assessment is crucial for managing perioperative cardiac risk in these patients.
Purpose:
- To evaluate the effectiveness of a diagnostic flowchart for preoperative ischemic heart disease (IHD) assessment in lung cancer patients undergoing surgery.
- To determine the incidence of perioperative myocardial ischemic events in patients with and without detected IHD.
Summary:
- Of 525 lung cancer patients, 24 had cardiovascular disease, most commonly IHD. A preoperative IHD assessment identified 18 patients (3.4%) with IHD.
- Myocardial revascularization was performed in 18 patients with known IHD before or during lung cancer surgery, with no major perioperative cardiac complications.
- Six patients (1.2%) experienced perioperative myocardial ischemic events despite the assessment, highlighting limitations in current IHD detection methods.
Impact:
- The current IHD assessment flowchart can be beneficial for perioperative management in lung cancer surgery.
- Improved diagnostic tools are essential for better identification of patients at risk for perioperative cardiac events, thereby reducing morbidity and mortality.
Abstract:
Among 525 patients with lung cancer who underwent an operation between 1985 and 1998, 24 patients who also had a cardiovascular disease, most commonly ischemic heart disease. We gave all of these patients a preoperative assessment for ischemic heart disease, done according to a diagnostic flow chart. Eighteen patients (3.4%) were found to have IHD. We performed myocardial revascularization before or simultaneously with an operation for lung cancer in patients who also have known IHD. None of these patients had major perioperative cardiac trouble. Inspite of our efforts, perioperative myocardial ischemic events occurred in 6 patients (1.2% of all patients) who were not detected by our preoperative IHD assessment. We conclude that this IHD assessment flow chart may be useful for proper perioperative management of patients undergoing lung surgery. However, more precise methods to detect patients with IHD will be necessary to improve their perioperative cardiac risk.
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