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Impact of Hematologic Malignancies on Outcome of Cardiac Surgery

Anita Nguyen1, Hartzell V Schaff1, Arman Arghami1

  • 1Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.

The Annals of Thoracic Surgery
|August 22, 2020
PubMed

Insights

Patients with hematologic malignancy undergoing cardiac surgery face similar early outcomes but reduced long-term survival compared to controls. Cardiac procedures should not be withheld from these patients if they stand to benefit.

Area of Science:

  • Cardiology
  • Hematology
  • Oncology

Background:

  • Previous studies indicate increased risks for patients with hematologic malignancy undergoing cardiac surgery.
  • This review compares clinical outcomes in cardiac surgery patients with and without a history of blood dyscrasia.

Purpose of the Study:

  • To compare clinical outcomes between cardiac surgery patients with a history of hematologic malignancy and matched controls without known blood dyscrasia.

Main Methods:

  • A retrospective review of 37,839 elective cardiac surgeries performed between January 1993 and June 2017.
  • 612 patients with hematologic malignancy were matched to 612 controls based on various factors.
  • Comparison of operative details, early postoperative complications, and late survival.

Main Results:

  • Patients with hematologic malignancy had lower hemoglobin but similar platelet counts.
  • Increased need for postoperative blood transfusions was observed in the malignancy group (47.4% vs 35.6%).
  • Reoperations for bleeding, stroke incidence, and 30-day mortality were similar; however, overall survival was reduced in patients with hematologic malignancy.

Conclusions:

  • Early postoperative outcomes for cardiac surgery patients with hematologic malignancy are comparable to matched controls.
  • Despite reduced late survival, cardiac surgery should be considered for patients with hematologic malignancy who would benefit from the procedure.
Abstract

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