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Left upper lobectomy after coronary artery bypass grafting. J Thorac Cardiovasc Surg 2015 Sep;150(3):531-5

Date

07/08/2015

Pubmed ID

26149098

DOI

10.1016/j.jtcvs.2015.05.066

Scopus ID

2-s2.0-84940453380 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

OBJECTIVE: Left upper pulmonary lobectomy or segmentectomy after coronary artery bypass grafting (CABG) risks injury to the grafts. We reviewed our experience.

METHODS: This is a retrospective review of a prospective database from 1 surgeon, of patients who underwent left upper lobectomy after having previous CABG.

RESULTS: Between June 1998 and June 2014, a total of 2207 patients underwent lobectomy by 1 surgeon; 458 (21%) had a left upper lobectomy, and 28 (6.1%) had had a previous CABG. Twenty-seven patients (96.4%) had a left internal mammary artery (LIMA) used for the bypass. Twenty-six patients (96.2%) had significant adhesions between their lung and the bypass grafts. Of patients who had a LIMA graft, 25 (92.6%) had the left upper lobe completely dissected free from their grafts, whereas 2 patients (7.1%) had a sliver of their lung left on the grafts. No patient had a postoperative myocardial infarction, and 30-day and 90-day survival rates were both 100%. All patients had a curative resection, and all had complete thoracic lymphadenectomy.

CONCLUSIONS: Left upper lobectomy after CABG, in patients with previous CABG and LIMA grafting, is safe. Usually the entire lung can be safely mobilized off the bypass grafts; if needed, a small sliver of lung can be left on the grafts. A curative resection is possible with minimal perioperative cardiac morbidity, and excellent 30- and 90-day mortality.

Author List

Wei B, Broussard B, Bryant A, Linsky P, Minnich DJ, Cerfolio RJ

Author

Paul L. Linsky MD Assistant Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aged
Alabama
Female
Humans
Internal Mammary-Coronary Artery Anastomosis
Lung Neoplasms
Lymph Node Excision
Male
Mammary Arteries
Middle Aged
Pneumonectomy
Retrospective Studies
Time Factors
Tissue Adhesions
Tomography, X-Ray Computed
Treatment Outcome