Detrimental effect of cardiopulmonary bypass(CPB) on malignant disease

Abstract

Patients with coronary artery disease associated with malignancy are a difficult group of patients to treat. The ideal approach to manage them is still controversial. Both problems can be manage by either a combined or staged operation. The use of CPB during revascularization of the myocardium among patients with malignant disease, may have an effect on dissimination of malignant cells. This was observed among two of our patients. We believe that the use of off-pump technique to revascularize the myocardium is a safe approach and can be performed either in combined or staged surgery to resect malignant disease.

Cancer-related deaths among different treatment options in chronic coronary artery disease

“…However, there is a report that demonstrates a lower cancer-specific survival rate in patients with colorectal cancer who had undergone cardiopulmonary bypass surgery [9].…”

Novel Apical Coring Device for Apicoaortic Conduit Insertion to Treat Off-Pump Aortic Stenosis, Coronary Disease, and Lung Cancer

“…The midterm prognosis of malignancies is significantly affected by a reduced immune response, which CPB may contribute. 5 On the other hand, any surgical decision to treat cancer introduces a high surgical risk among patients with concurrent untreated cardiac disease. Beyond perturbations of immune response, systemic heparinization required during open heart surgery can cause intrapulmonary hemorrhage and excessive bleeding during pulmonary resection.…”

Surgical Management of Coronary Artery Disease Associated with Malignancy

“…The development of metastasis after the use of CPB has been reported in the early postoperative period after surgical resection of a known malignant disease or even from an undiagnosed hidden malignancy 84,85 …”