Journal of Acute Care

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VOLUME 3 , ISSUE 1 ( January-April, 2024 ) > List of Articles

Original Article

Approach to Noncardiac Surgery in Cardiac Patients: Feasibility of Simultaneous Cardiac and Noncardiac Surgery

Lutphun Nahar, Raghu Bheemaiah

Keywords : Cardiac surgery, Coronary artery bypass grafting, Noncardiac surgery, Simultaneous surgery

Citation Information : Nahar L, Bheemaiah R. Approach to Noncardiac Surgery in Cardiac Patients: Feasibility of Simultaneous Cardiac and Noncardiac Surgery. 2024; 3 (1):4-7.

DOI: 10.5005/jp-journals-10089-0099

License: CC BY-NC 4.0

Published Online: 30-04-2024

Copyright Statement:  Copyright © 2024; The Author(s).


The study aimed to investigate the feasibility of simultaneous cardiac and noncardiac surgery at a tertiary care high-volume center. The clinical records of all patients who underwent simultaneous cardiac and noncardiac surgery between July 2017 and July 2022 were reviewed. Preoperative, intraoperative, and postoperative clinical data were collected and analyzed. Patients were followed up to hospital discharge. Fourteen patients underwent simultaneous cardiac and noncardiac surgery. Patients were hemodynamically stable throughout the follow-up. Postoperative elective intermittent positive pressure ventilation (IPPV) duration was 4–8 hours (mean 5.4 ± 1.1 hours). The intensive care unit (ICU) stay varied between 3 and 22 (mean of 7.9 ± 6.4) days, and the total hospital stay varied from 8 to 30 (mean of 13.8 ± 6.8) days. None of the patients developed postoperative complications, namely bleeding needing re-exploration, pulmonary infection with hypoxemia, acute renal failure, or wound infection. There were no perioperative major adverse cardiac events such as myocardial infarction, heart failure, significant life-threatening arrhythmia, cardiac arrest, or acute ischemic stroke during the index hospital stay. There was no mortality in this cohort. Simultaneous cardiac and noncardiac surgery in patients who are suffering from heart disease is safe and feasible with a satisfactory postoperative outcome when stepwise stratification and evaluation during the preoperative period and efficient and expert management during the perioperative period have been executed.

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  1. Yang Y, Xiao F, Wang J, et al. Simultaneous surgery in patients with both cardiac and non-cardiac diseases. Patient Prefer Adher 2016;10:1251–1258. DOI: 10.2147/PPA.S100588
  2. Fleisher LA, Fleischmann KE, Auerbach AD, et al. American College of Cardiology. American Heart Association 2014 ACC/AHA Guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. J Am Coll Cardiol 2014;64(22):e77–e137. DOI: 10.1016/j.jacc.2014.07.944
  3. Rao V, Todd TR, Weisel RD, et al. Results of combined pulmonary resection and cardiac operation. Ann Thorac Surg 1996;62(2):342–346. PMID: 8694588.
  4. Davydov MI, Akchurin RS, Gerasimov SS, et al. Simultaneous operations in thoraco-abdominal clinical oncology. Eur J Cardiothorac Surg 2001;20(5):1020–1024. DOI: 10.1016/S1010-7940(01)00922-8
  5. Mariani MA, Boven WJ, Duurkens VA, et al. Combined off-pump coronary surgery and right lung resections through midline sternotomy. Ann Thorac Surg 2001;71(4):1343–1344. DOI: 10.1016/s0003-4975(00)02355-9
  6. Saxena P, Tam RK. Combined off-pump coronary artery bypass surgery and pulmonary resection. Ann Thorac Surg 2004;78(2):498–501. DOI: 10.1016/j.athoracsur.2004.02.026
  7. Dyszkiewicz W, Jemielity MM, Piwkowski CT, et al. Simultaneous lung resection for cancer and myocardial revascularization without cardiopulmonary bypass (off-pump coronary artery bypass grafting). Ann Thorac Surg 2004;77(3):1023–1027. DOI: 10.1016/j.athoracsur.2003.07.041
  8. Carrascal Y, Gualis J, Arevalo A, et al. Cardiac surgery with extracorporeal circulation in cancer patients: influence on surgical morbidity and mortality, and on survival. Rev Esp Cardiol 2008;61(4):369–375. PMID: 18405517.
  9. Riviere AB, Knaepen P, Swieten HV, et al. Concomitant open-heart surgery and pulmonary resection for lung cancer. Eur J Cardiothorac Surg 1995;9(6):310–313. DOI: 10.1016/s1010-7940(05)80188-5
  10. Schoenmakers MC, Boven WJ, Bosch J, et al. Comparison of on-pump or off-pump coronary artery revascularization with lung resection. Ann Thorac Surg 2007;84(2):504–509. DOI: 10.1016/j.athoracsur.2007.04.005
  11. Sabol F, Toporcer T, Kolesár A, et al. Case report: surgical management of a patient with combined heart pathologies and lung cancer. A simultaneous coronary artery bypass surgery, aortic valve replacement, tricuspid valve repair and pulmonary resection. Cor Vasa 2014;56(1):e75–e79. DOI: 10.1016/j.crvasa.2013.07.007
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