HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Ralph A. Schmid Paul R. Vogt Walter Weder Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schmid, R. A. Articles by Weder, W. Search for Related Content PubMed PubMed Citation Articles by Schmid, R. A. Articles by Weder, W.

Eur J Cardiothorac Surg 1999;15:585-591
© 1999 Elsevier Science NL

Lung volume reduction surgery combined with cardiac interventions

^a Division of Thoracic Surgery, Department of Surgery, Department of Internal Medicine, University Hospital, Zürich, Switzerland
^b Pulmonary Division, Department of Internal Medicine, University Hospital, Zürich, Switzerland
^c Division of Cardiology, Department of Internal Medicine, University Hospital, Zürich, Switzerland

Received 22 September 1998; received in revised form 16 February 1999; accepted 2 March 1999.

Corresponding author. Tel.: +41-1-255-8802; fax: +41-1-255-8805

Objective: Postoperative course and functional outcome were evaluated in patients who underwent lung volume reduction surgery (LVRS) or in combination with valve replacement (VR), percutaneous transluminal coronary angioplasty (PTCA), placement of a stent, or coronary artery bypass grafting (CABG). Methods: Patients with severe bronchial obstruction and hyperinflation due to pulmonary emphysema were evaluated for lung volume reduction surgery. Cardiac disorders were screened by history and physical examination and assessed by coronary angiography. Nine patients were accepted for LVRS in combination with an intervention for coronary artery disease (CAD). In addition, three patients with valve disease and severe emphysema were accepted for valve replacement (two aortic-, one mitral valve) only in combination with LVRS. Functional results over the first 6 months were analysed. Results: Pulmonary function testing demonstrates a significant improvement in postoperative FEV₁ in patients who underwent LVRS combined with an intervention for CAD. This was reflected in reduction of overinflation (residual volume/total lung capacity (RV/TLC)), and improvement in the 12-min walking distance and dyspnea. Median hospital stay was 15 days (10–33). One patient in the CAD group died due to pulmonary edema on day 2 postoperatively. One of the three patients who underwent valve replacement and LVRS died on day 14 postoperatively following intestinal infarction. Both survivors improved in pulmonary function, dyspnea score and exercise capacity. Complications in all 12 patients included pneumothorax (n=2), hematothorax (n=1) and urosepsis (n=1). Conclusion: Functional improvement after LVRS in patients with CAD is equal to patients without CAD. Mortality in patients who underwent LVRS after PTCA or CABG was comparable to patients without CAD. LVRS enables valve replacement in selected patients with severe emphysema otherwise inoperable.

Key Words: Lung volume reduction surgery • Cardiac disease • Outcome

This article has been cited by other articles:

				M. Decramer Treatment of chronic respiratory failure: lung volume reduction surgery versus rehabilitation Eur. Respir. J., November 16, 2003; 22(47_suppl): 47s - 56s. [Abstract] [Full Text] [PDF]

				R. L. Berger, B. R. Celli, A. L. Meneghetti, P. H. Bagley, C. D. Wright, E. P. Ingenito, A. Gray, and G. L. Snider Limitations of randomized clinical trials for evaluating emerging operations: the case of lung volume reduction surgery Ann. Thorac. Surg., August 1, 2001; 72(2): 649 - 657. [Abstract] [Full Text] [PDF]

				J. B. Shrager, B. W. Kozyak, J. R. Roberts, J. E. Bavaria, J. S. Friedberg, L. R. Kaiser, and B. R. Rosengard Successful experience with simultaneous lung volume reduction and cardiac procedures J. Thorac. Cardiovasc. Surg., July 1, 2001; 122(1): 196 - 197. [Full Text] [PDF]

				J. Hamacher, E. W. Russi, and W. Weder Lung Volume Reduction Surgery : A Survey on the European Experience Chest, June 1, 2000; 117(6): 1560 - 1567. [Abstract] [Full Text] [PDF]

				M. A. de Castro Current Controversies in Surgical Therapy for Emphysema Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 2000; 4(1): 26 - 30. [Abstract] [PDF]