Surgical Management of Coronary Artery Disease Associated with Malignancy

Darwazah, F.R.C.S. Ahmad K.

doi:10.1111/j.1540-8191.2012.01514.x

Cited by 8 publications

(5 citation statements)

References 81 publications

(202 reference statements)

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“…Simultaneous surgery has already been carried out in the 1980s for combined treatment of pulmonary neoplasia and cardiac surgical disorders. In one stage operation, CABG is performed first, considering cardiac surgery is an aseptic surgery, and cardiac revascularization is carried out first to avoid perioperative myocardial ischemia [25, 26]. Compared to a two-stage operation, a one-stage operation also has advantages including a single induction of general anesthesia, shorter overall hospital stay, and reduced cost of treatment [27].…”

Section: Discussionmentioning

confidence: 99%

Feasibility and efficacy of simultaneous off-pump coronary artery bypass grafting and esophagectomy in elderly patients

Liu

Wang

et al. 2017

Oncotarget

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IntroductionTo analyze the outcomes of off-pump coronary artery bypass grafting (OPCABG) and esophagectomy simultaneously for patients with coronary artery disease (CAD) and coexisting esophageal cancer.MethodsTwenty-two patients with CAD and coexisting esophageal cancer underwent combined surgical interventions were subjected to the study. OPCABG was performed first, followed by esophagectomy. All the corresponding data including clinicopathological characteristics and postoperative outcomes were all investigated.ResultsAll the combined procedures were performed successfully. The average number of grafts was 2.36. Tumors were located at the middle third of the esophagus in 5 patients, at the lower third of the esophagus in 8 patients, at the esophageal gastric junction (EGJ) in 9 patients, respectively. The operations were carried out through a left lateral thoracotomy approach in 21 patients while a median sternotomy and left lateral thoracotomy approach was used in 1 patient for his condition rapidly worsened. Postoperatively, pneumonia occurred in 4 patients (18.2%). During the follow-up, three patients died of cancer metastasis /recurrence (6, 18, 37 months) and one died of pneumonia (1 month). The cumulative 5 years survival rate is 52.9%.ConclusionsThe combined procedure of OPCABG and esophagectomy is a safe and effective treatment option for patients with severe CAD and esophageal cancer.

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Section: Discussionmentioning

confidence: 99%

Feasibility and efficacy of simultaneous off-pump coronary artery bypass grafting and esophagectomy in elderly patients

Liu

Wang

et al. 2017

Oncotarget

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“…In our study, two cases of simultaneous CABG and tumor surgery, including one case each of colon cancer and malignant thymoma, were performed without complications related to perioperative incisional infection, severe bleeding, or a lung infection. Patients with tumors undergoing staged CABG and tumor surgery had the advantage of a low incidence of adverse cardiovascular events, the interval between the two procedures ranged from 5 to 60 days, and it was also considered that there was no significant correlation between the recurrence or metastasis of the tumor and no correlation to the time between staged procedures [23]. In this study, four patients underwent coronary artery bypass surgery (esophageal cancer, bladder cancer, lung cancer, and rectal cancer) and staged radical tumor surgery, with an interval of approximately 1-3 months between the two procedures, and there were no in-hospital deaths, and no tumor metastasis or recurrence was found during the follow-up periods, and no cardiovascular adverse events such as angina pectoris, acute myocardial infarction, ventricular arrhythmia, sudden cardiac death or heart failure occurred.…”

Section: Discussionmentioning

confidence: 99%

Coronary artery bypass grafting in patients with malignancy: a single-institute case series of eight patients

Zhang

et al. 2022

BMC Surg

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Background The surgical strategy among patients with malignancy and coronary artery disease (CAD) remains controversial. In this study, we present the experiences of coronary artery bypass grafting (CABG) in patients with malignancy and analyzed the treatment outcomes. Methods From January 2011 to October 2021, eight patients combined with coronary artery disease and malignancy, six of them with three-vessel disease and two with anterior descending branch lesions on coronary angiography. The age ranged from 54 to 73 years (61.8 ± 7.7years). Four patients underwent CABG and staging for surgical oncology, and 2 patients underwent CABG and surgical oncology simultaneously. Four patients underwent CABG procedure with cardiopulmonary bypass (on-pump CABG), and the other patients underwent the procedure without cardiopulmonary bypass (off-pump CABG). All patients were followed up for 3 to 96 months (40.4 ± 31.5 months) postoperatively. Results The mean number of grafts was 2.6 ± 1.1, there was no in-hospital death, postoperative myocardial infarction, and stroke. Among the eight patients, one patient received chemotherapy and radiation before bypass surgery, which occurred postoperatively pulmonary infection, and the rest of 7 patients had no major adverse cardiovascular events during follow-up periods. Conclusion Based on the results of the present study, simultaneous or staged CABG and oncologic surgery according to the TNM stage of the tumor and cardiac assessment is an effective treatment for patients with severe CAD combined with malignancy.

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“…Patients with acute coronary syndrome, unstable angina pectoris or acute myocardial infarction should undergo myocardial revascularisation before their surgical treatment for neoplastic diseases is scheduled 4. On the other hand, stable coronary artery disease can be managed medically, which does not preclude the definitive treatment of the neoplastic disease 4…”

Section: Discussionmentioning

confidence: 99%

Staged off-pump coronary artery bypass grafting and radical nephrectomy in a patient with multivessel coronary artery disease and a renal tumour

2014

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Coronary artery diseases and neoplastic disorders are the leading causes of morbidity and mortality in the elderly. Recently, controversial approaches have been raised about the treatment of cases with concomitant occurrence of coronary artery diseases and malignancies. The detrimental effects of cardiopulmonary bypass on neoplastic cells are always a challenge for such cases. We present a case of a large renal tumour associated with a recently symptomatic coronary artery disease which was successfully treated with staged off-pump coronary artery bypass grafting followed by radical nephrectomy. In such patients, off-pump revascularisation is favourable in order to decrease the risk of cancer spreading when compared to traditional on-pump cases. In our opinion, staged off-pump coronary arterial revascularisation followed by definitive surgical treatment for the malignancy is a safe and effective treatment modality in patients with coronary artery disease and oncological diseases.

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Surgical Management of Coronary Artery Disease Associated with Malignancy

Cited by 8 publications

References 81 publications

Feasibility and efficacy of simultaneous off-pump coronary artery bypass grafting and esophagectomy in elderly patients

Feasibility and efficacy of simultaneous off-pump coronary artery bypass grafting and esophagectomy in elderly patients

Coronary artery bypass grafting in patients with malignancy: a single-institute case series of eight patients

Staged off-pump coronary artery bypass grafting and radical nephrectomy in a patient with multivessel coronary artery disease and a renal tumour

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