ArticleJournal of thoracic disease2025
Long-term survival of patients undergoing off-pump coronary artery bypass grafting combined with pulmonary lobectomy.
Article in Journal of thoracic disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The validity and safety of simultaneously performing coronary artery bypass grafting (CABG) and lung cancer resection remain inconclusive. This study examined the clinical progression of patients undergone this surgery. Methods: Fifty-seven patients who underwent concurrent off-pump CABG (OPCABG) and pulmonary lobectomy between May 2006 and December 2019 in Beijing Anzhen Hospital were retrospectively analyzed. Baseline characteristic and clinical data of patients were collected, and postoperative follow-up was performed to evaluate the prognosis. Results: All procedures were performed with median or parasternal incision, and thoracoscope was used in 15 of them. No intraoperative deaths were reported. An average of 2.52±0.90 coronary vessels were grafted per procedure. One patient died in hospital due to postoperative low cardiac output, another due to respiratory failure. In Cox multivariate regression analysis, age >69 years [hazard ratio (HR): 1.223, 95% confidence interval (CI): 1.067-1.402, P=0.004, area under the curve (AUC) =0.657] and tumor stage >III (HR: 5.384, 95% CI: 1.917-15.125, P=0.001, AUC =0.715) emerged as significant predictors of adverse event risk for survival. During the 17-year follow-up, the mean survival time was 85.39±49.70 months, with a primary endpoint of death reached by 21.05% (12/57) of patients. All deaths were attributed to tumor progression, and there were no new myocardial infarction or heart failure readmissions. Conclusions: OPCABG combined with pulmonary resection is safe and effective in the treatment of patients with concomitant coronary artery disease (CAD) and lung cancer. Age and tumor stage were significantly correlated with postoperative survival. The predictive value of tumor stage above III surpasses that of age in prognostic assessment. For patients aged 69 years and with tumors of stage III or higher, surgical decision-making requires careful consideration due to the potentially increased risk of adverse outcomes.
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