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[Coronary artery bypass grating 13 years after pneumonectomy]
T Shibata1, S Suehiro, E Kimura
1Second Department of Surgery, Osaka City University Medical School, Japan.
[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|July 1, 1994
Summary
Coronary artery bypass grafting (CABG) is feasible after pneumonectomy for lung cancer. Careful patient selection and management are crucial for successful open-heart surgery in these cases.
Area of Science:
- Cardiology
- Thoracic Surgery
- Oncology
Background:
- Coronary artery disease (CAD) management in patients with a history of lung cancer surgery presents unique challenges.
- Pneumonectomy significantly alters thoracic anatomy and pulmonary function, potentially increasing surgical risks.
Observation:
- A case report details coronary artery bypass grafting (CABG) in a patient 13 years post-left pneumonectomy for lung cancer.
- Preoperative pulmonary function tests showed reduced vital capacity (55%) and forced expiratory volume in 1 second (77%).
- A specialized retractor facilitated surgical access due to cardiac displacement.
Findings:
- Triple CABG was successfully performed using saphenous vein grafts.
- Transient intraoperative hypoxemia occurred after extracorporeal circulation.
- The patient experienced an uneventful recovery and was discharged on postoperative day 57.
Implications:
- This case demonstrates the possibility of performing open-heart surgery, specifically CABG, in patients who have undergone pneumonectomy for lung cancer.
- Adequate pulmonary function and meticulous perioperative management are key factors for successful outcomes.
- This report is the first of its kind in Japan, expanding the understanding of surgical options for this patient population.