Perioperative Results of Combined Heart Surgery and Lung Resection: Local Experience of Krasnodar Region

Highlights The relevance of the problem is due to the increase in the number of patients with combined heart and lung diseases requiring surgical treatment, which dictates the need to develop effective and safe surgical techniques. Combined surgery allows for shorter hospital stays and overall recovery times, reduces the need for repeated anesthesia, ensuring optimization of the treatment process and a reduction in the overall burden on the patient's body. Background. A relatively small number of patients have concomitant cardiac and pulmonary lesions requiring surgical intervention, the prevalence of such patients is increasing. Treatment options include simultaneous or staged surgical procedures. However, there are concerns regarding the potential increase in mortality and morbidity with simultaneous surgery, as well as the adequacy of the impact on the lungs during cardiac surgery. Aim. To evaluate intra- and postoperative outcome indicators during combined heart and lung surgeries in everyday clinical practice. Methods. The work is devoted to the study of the outcomes of diagnosis, treatment and dynamic observation of patients operated on at the Research Institute – Regional Clinical Hospital No. 1 named after prof. S.V. Ochapovsky, Krasnodar, under the guidance of Academician of the Russian Academy of Sciences V.A. Porkhanov from January 2015 to June 2024. Patients were divided into two groups according to the method of restoring myocardial blood supply: group A – simultaneous operations coronary artery bypass grafting + lung resection (n = 71), group B – angioplasty with stenting of the coronary arteries followed by lung surgery (n = 94). Results. The average age of patients in the study was 64.1 ± 12.4 years. The following were significant in-hospital complications: acute heart failure – 9.86% versus 0%, p = 0.02; atrial fibrillation – 15.49.0% versus 4.25%, p = 0.013; sepsis – 8.45% versus 0%, p = 0.004; post-hypoxic encephalopathy – 9.86% versus 0%, p = 0.002. No repeat thoracotomies due to bleeding were recorded. No fatal outcomes were observed in the stented group versus 2 patients in the coronary artery bypass grafting group, however, this indicator did not reach statistically significant difference. Conclusion. Our study demonstrated that combined cardiac surgery and lung tumor resection had a low mortality rate and an acceptable complication rate. Given the small number of patients included in the study, our findings need to be further confirmed in a large-scale prospective study.