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Updated: Apr 15, 2026
Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
[Management of patients with ischemic heart disease in lung cancer resection]
Mitsuru Maki1, Hiroyoshi Tsubochi, Tetsuya Endo
1Department of General Thoracic Surgery, Saitama Medical Center, Jichi Medical School, Saitama, Japan.
Insights
Patients with lung cancer and ischemic heart disease undergoing surgery had low cardiac event rates after coronary interventions. Coronary stenting showed no major adverse events, including stent thrombosis.
Area of Science:
- Cardiology
- Thoracic Surgery
- Oncology
Context:
- Concomitant ischemic heart disease (IHD) is a concern in lung cancer patients undergoing surgery.
- Prevalence of IHD in lung cancer surgical patients is approximately 4.7% in this cohort.
- Management strategies for IHD in this population require careful consideration.
Purpose:
- To evaluate the outcomes of cardiac interventions in lung cancer patients with concomitant IHD.
- To assess the safety and efficacy of coronary artery procedures, including stenting, in this high-risk group.
- To analyze the impact of perioperative medications on surgical outcomes.
Summary:
- A review of 1,047 lung cancer patients revealed 49 with IHD.
- 41 patients underwent coronary angiography, with 26 receiving coronary stents (bare metal or drug-eluting) and 3 undergoing balloon angioplasty.
- Five patients had coronary artery bypass grafting, and eight had coronary spastic angina. Postoperative major adverse cardiac events were 6.1% with a 2.0% fatality rate. No cardiac events occurred in stented patients. Perioperative aspirin and heparinization did not significantly increase bleeding risk.
Impact:
- Coronary interventions, particularly stenting, appear safe and effective in lung cancer patients with IHD.
- This study supports the feasibility of managing concomitant IHD in lung cancer surgical candidates.
- Findings suggest that perioperative anticoagulation and antiplatelet therapies can be safely administered without significantly increasing intraoperative bleeding.
Abstract:
We reviewed the medical records of 1,047 consecutive patients with lung cancer who underwent surgery between April 2005 and March 2014. Among them 49 patients(4.7%)had concomitant ischemic heart disease. Coronary angiography showed coronary artery stenosis in 41 patients, of whom 14 patients received bare metal stents and 9 patients received drug-eluting stents. Three patients underwent plain old balloon angioplasty. Coronary artery bypass graft were performed in 5 patients. Eight patients with coronary spastic angina were also included in the present study. Aspirin administration was continued in 9 patients and heparinization was performed in 14 patients during the perioperative period. Postoperative major adverse cardiac events within 30-days occurred in 3 patients(6.1%)resulting in a single fatality(2.0%). No major cardiac events, including stent thrombosis, developed in patient who received coronary stent. Perioperative aspirin administration and heparinization were not significantly associated with intraoperative bleeding during the operation.
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