[Peri- and postoperative courses in patients undergoing concomitant cardiac and pulmonary operations]

We studied peri- and postoperative courses in patients undergoing concomitant cardiac and pulmonary operations (CCPO), which included pulmonary resection and coronary artery bypass grafting (CABG). Of eight patients who had lung cancer and ischemic heart disease (IHD), six underwent CCPO and two patients first had percutaneous transluminal coronary angioplasty (PTCA) followed by lung surgery at an interval after the first procedure. Twelve patients with lung cancer who underwent only pulmonary surgery and 13 patients with IHD who were treated with CABG were studied as controls. We compared peri- and postoperative characteristics among these groups of patient. Operating time, bleeding volume during surgery, amount of drainage discharge within 24 hours after the operation, and ICU days were significantly increased in the CCPO group in comparison with the two control groups. In the CCPO group, mechanical ventilatory support time and administration days after the operation were significantly increased in comparison with the lung operation group, but not in comparison with CABG group. The two patients who sequentially underwent PTCA and lung surgery had postoperative courses similar to the CCPO patients. All CCPO patients were ambulatory upon discharge. None of the CCPO patients died from postoperative complications involving the respiratory tract or the circulatory system. Our data suggest that CCPO is available for patients with both heart and lung diseases when complications can be avoided by appropriate management, although these procedures are extremely invasive. We believe that CCPO should be attempted in patients with definite indications for such a procedure.