Post-pneumonectomy coronary artery bypass graft surgery
Shirin Siddiqi1, Amanpreet Sherwal2
1Surgery, Conemaugh Health System, Johnstown, Pennsylvania, USA ssiddiqi@conemaugh.org.
BMJ Case Reports
|May 27, 2024
Summary
Coronary artery bypass graft (CABG) surgery after pneumonectomy is challenging due to anatomical changes. This case report details a successful on-pump CABG in a patient with a history of left pneumonectomy, highlighting safe surgical management.
Area of Science:
- Cardiothoracic Surgery
- Thoracic Oncology
- Cardiac Surgery
Background:
- Post-pneumonectomy patients present unique challenges for cardiac surgery due to significant anatomical alterations.
- Reduced respiratory reserve (45%-55%) and mediastinal shift complicate access to the heart and great vessels.
Observation:
- A male patient in his 70s with a history of left pneumonectomy required coronary artery bypass graft (CABG) surgery.
- The patient underwent a successful on-pump CABG utilizing left internal mammary artery and great saphenous vein grafts.
Findings:
- The patient was successfully extubated postoperatively and discharged in stable condition.
- This case demonstrates the feasibility of on-pump CABG in a post-pneumonectomy patient.
Implications:
- This report contributes to the limited literature on managing high-risk patients undergoing CABG after pneumonectomy.
- Further research is needed to establish optimal management protocols for these complex cases.
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