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  • Title: Combined one stage cardiac and pulmonary surgery by median sternotomy.
    Author: Adant JP, Defraigne JO, Limet R.
    Journal: Acta Chir Belg; 1990; 90(4):197-202. PubMed ID: 2239038.
    Abstract:
    From 1985 to 1989, 6 patients underwent a pulmonary surgical procedure simultaneously with a cardiac operation. All patients were male with a mean age of 60 +/- 8 years. The cardiac procedures included: 1 aortic and 1 mitral valve replacement, 3 coronary artery bypass grafts and 1 closure of an atrial septal defect. Four patients had primary pulmonary nodules: 2 bronchogenic carcinomas and 2 benign hamartomas. They presented with cardiac symptoms, and lung nodules were incidentally found on preoperative Chest X-Rays. The 2 last patients had pulmonary metastases of colonic neoplasms previously resected, respectively 3 and 6 years before. After completion of the cardiac procedures, during the rewarming of the patient, the pulmonary resection was performed on a deflated lung, via the median sternotomy. Pulmonary procedures included: right upper segmentectomy (n = 1), left pneumonectomy (n = 1), left interior lobectomy (n = 1), right middle lobectomy (n = 1), left upper wedge resection (n = 1), and right upper lobe wedge resection (n = 1). All patients were extubated on day one. One patient died from rythm disturbances on day 13. All other patients are alive with a mean survival of 30 months. The authors conclude that combined surgery is feasible in selected cases. Sternal approach is not a limitation to pulmonary resection.
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