Objective: The management of patients requiring both cardiac and pulmonary surgeries presents a unique challenge, given the rarity of coexisting conditions necessitating simultaneous interventions. This study aimed to evaluate the surgical outcomes of performing lung resection and cardiac surgery in a single operative session. The primary objective of this study was to assess the early and midterm outcomes of a combined surgical strategy for treating coexistent heart and lung diseases. Specifically, it seeks to understand the feasibility, safety, and efficacy of simultaneous operations compared with traditional staged approaches.
Methods: This retrospective analysis included 25 patients who underwent concurrent thoracic and cardiac surgery between 2012 and 2021. We examined the types of cardiac and pulmonary surgeries performed, the necessity of additional thoracotomy beyond median sternotomy, early postoperative outcomes, including operative mortality, the incidence of re-exploration due to complications, and pulmonary complications. Long-term outcomes were evaluated through direct outpatient visits or telephonic interviews.
Results: The average age was 62.6±9.4 years, with six females among the participants. Median sternotomy was the primary surgical approach for all patients, with one case requiring additional thoracotomy. Surgical interventions included 13 isolated coronary artery bypass grafting (CABG) procedures, 5 valve surgeries, 6 combined CABG and valve surgeries, and 1 Bentall procedure. Pulmonary interventions included 15 wedge resections and 10 lobectomies with lymph node dissection. There were no cases of operative mortality. Re-exploration was necessary in one patient because of bleeding (p>0.05). Post-extubation hypoxemia was not observed, and pulmonary complications occurred in two patients (p>0.05).
Conclusion: Simultaneous execution of thoracic and cardiac surgeries is feasible, demonstrating low rates of postoperative mortality and complications, thereby offering a viable alternative for patients with coexisting cardiac and pulmonary conditions. This study underscores the potential benefits of a simultaneous surgical approach in selected patients, suggesting that with appropriate preoperative planning and surgical expertise, combined operations can be safely conducted, minimizing the need for multiple hospitalizations and surgeries.