Early and Long Term Results of Our Open Heart Surgical Operations in the Presence of Active Oncological Diseases
1Koşuyolu Yüksek İhti̇sas Eği̇ti̇m Ve Araştirma Hastanesi̇, Kalp Ve Damar Cerrahi̇si̇, İstanbul, Turkey
2Koşuyolu Yüksek İhti̇sas Eği̇ti̇m Ve Araştirma Hastanesi̇, Göğüs Cerrahisi , İstanbul, Turkey
3 Koşuyolu Yüksek İhti̇sas Eği̇ti̇m Ve Araştirma Hastanesi̇, Gastroenteroloji Cerrahisi , İstanbul, Turkey
Keywords: coronary artery bypass surgery, heart surgery, active cancer, lung cancer, breast cancer
Objectives: Active cancer and heart disease, which share similar environmental and biological characteristics, can occur concomitantly. Open heart surgery may be required for these patients when indicated. The aim of this study is to demonstrate the early and long-term results and discuss the intervention strategy in patients with different types of active malignancies, who underwent open heart surgery.
Patients and Methods: Between January 2012 and May 2020, open heart surgery was performed on 10 patients with active malignancies. The mean age was 65.5 (52–77), and 4 of the patients were female. 2 patients were operated emergently due to advanced pleural effusion. AVR+CABG, CABG, CABG+left upper lobectomy and AVR+MVR were performed in 4 patients with lung cancer; AVR+CABG were performed in 1 patient with colon cancer; CABG was performed in 4 patients each with one of the following conditions: lymphoma, breast cancer, essential thrombocytosis, meningioma); and mass resection operation from the left atrium and left ventricle was performed in one patient with osteosarcoma.
Results: 8 patients were discharged and 2 patients died in the early postoperative period. Postoperative left hemiparesis developed in 1 patient. 6-month, 1-year and 5-year survival rates were 79%, 37.5% and 25%, respectively.
Conclusion: Open heart surgery can be successfully performed with acceptable mortality and morbidity rates on the high-risk patient group with active cancer. We believe that, where percutaneous coronary intervention and/or TAVI are not considered or deemed appropriate, surgical intervention should be performed with careful patient selection in patients with multi-vessel coronary artery disease, coronary artery stenosis +aortic stenosis, and in cases requiring double valve replacement.