Concomitant cardiac and pulmonary operations

J. M. Piehler, V. F. Trastek, P. C. Pairolero, J. R. Pluth, G. K. Danielson, Hartzell V Schaff, T. A. Orszulak, F. J. Puga

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Abstract

From 1965 through 1983, 43 patients underwent concomitant cardiac and pulmonary procedures at our institution. Most patients presented with cardiac symptoms and were incidentally found to have a roentgenographically indeterminate lung nodule. The pulmonary diagnosis of 38 patients was unknown preoperatively, and nine of these had a malignant lesion. All 43 cardiac procedures necessitated extracorporeal circulation. Thirty-one patients had benign pulmonary disease, 10 had bronchogenic carcinoma, and two had metastatic carcinoma. Concomitant pulmonary procedures were performed via median sternotomy and included single wedge resections in 32 patients, lobectomy in seven, multiple wedge resections in three, and pneumonectomy in one. Most resections were performed either before or after institution of bypass, without systemic anticoagulation. Of the two operative deaths (4.6%), one was related to intraparenchymal pulmonary hemorrhage after multiple wedge resections during anticoagulation. Thus, pulmonary resections performed during anticoagulation may be associated with increased risk and probably should be avoided. The second death was cardiac in origin and not related to pulmonary resection. The remaining patients recovered uneventfully. Definitive correction of both cardiac and pulmonary disease can be performed at one operation via a single incision with safety and benefit to the carefully selected patient.

Original languageEnglish (US)
Pages (from-to)662-667
Number of pages6
JournalJournal of Thoracic and Cardiovascular Surgery
Volume90
Issue number5
StatePublished - 1985

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Piehler, J. M., Trastek, V. F., Pairolero, P. C., Pluth, J. R., Danielson, G. K., Schaff, H. V., Orszulak, T. A., & Puga, F. J. (1985). Concomitant cardiac and pulmonary operations. Journal of Thoracic and Cardiovascular Surgery, 90(5), 662-667.