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Left upper lobectomy after coronary artery bypass grafting
Benjamin Wei1, Brett Broussard1, Ayesha Bryant1
1Division of Cardiothoracic Surgery, University of Alabama at Birmingham Medical Center, Birmingham, Ala.
The Journal of Thoracic and Cardiovascular Surgery
|July 8, 2015
Summary
Left upper lobectomy after coronary artery bypass grafting (CABG) is safe, even with left internal mammary artery (LIMA) grafts. Lung dissection from grafts is usually complete, ensuring curative resection with excellent survival rates.
Area of Science:
- Cardiothoracic Surgery
- Thoracic Oncology
- Cardiovascular Surgery
Background:
- Coronary artery bypass grafting (CABG) is a common procedure.
- Left upper lobectomy is a surgical option for lung conditions.
- Performing left upper lobectomy after CABG poses risks to grafts.
Purpose of the Study:
- To review the safety and outcomes of left upper lobectomy in patients with prior CABG.
- To assess graft injury and oncologic outcomes in this patient population.
Main Methods:
- Retrospective review of a prospective database from a single surgeon.
- Inclusion criteria: patients undergoing left upper lobectomy after previous CABG.
- Data collected on graft status, dissection, complications, and survival.
Main Results:
- 28 patients with prior CABG underwent left upper lobectomy.
- 27 patients (96.4%) had left internal mammary artery (LIMA) grafts.
- Complete dissection from grafts was achieved in 92.6% of LIMA cases; no myocardial infarction occurred; 30- and 90-day survival were 100%.
Conclusions:
- Left upper lobectomy is safe in patients with prior CABG, particularly those with LIMA grafts.
- Complete lung mobilization from grafts is typically feasible.
- Curative resection is achievable with minimal cardiac morbidity and excellent survival.
