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): Thomas J. Birdas David Haybron Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Fecher, A. M. Articles by Caushaj, P. F. Search for Related Content PubMed PubMed Citation Articles by Fecher, A. M. Articles by Caushaj, P. F. Related Collections Cardiac - other Coronary disease

Eur J Cardiothorac Surg 2004;25:537-540
© 2004 Elsevier Science NL

Cardiac operations in patients with hematologic malignancies

^a Department of Surgery, Temple University School of Medicine Clinical Campus at the Western Pennsylvania Hospital, 4800 Friendship Ave, Pittsburgh, PA 15224, USA
^b Department of Cardiothoracic Surgery, Allegheny General Hospital, Pittsburgh, PA, USA

Received 12 October 2003; received in revised form 1 December 2003; accepted 3 December 2003.

^* Corresponding author. Tel.: +1-412-578-6880; fax: +1-412-578-1434
e-mail: afecher{at}wpahs.org

Objectives: Patients with hematologic malignancies are frequently in need of major cardiac operations. Previous reports suggest an increased risk for perioperative complications in these immunodeficient patients. Methods: Patients diagnosed with any type of hematologic malignancy who underwent open-heart surgery at our institution between 7/1996 and 6/2002 were identified. Their hospital charts were reviewed; demographics, perioperative data and outcomes were recorded. Results: There were 24 patients (20 men, 4 women); mean age was 68±13 years (range 31–84 years). Ten patients had chronic lymphocytic leukemia, seven non-Hodgkin lymphomas, three multiple myeloma and one Hodgkin's disease, chronic myelocytic leukemia, hairy cell leukemia and cutaneous T-cell lymphoma each. The mean pre-operative duration of the hematologic disease was 6.6 years. Twenty-two patients underwent coronary artery bypass grafting (with valve replacement in three patients) and two patients had isolated valve replacement. There was one in-hospital death (4.1%). Twelve patients (50%) had a minor or major complication. Seven reoperations were required—five during the same admission (one for mediastinal bleeding, one for an expanding femoral pseudoaneurysm, one for acute cholecystitis and two for IACD/pacer insertion) and two within 30 days (one for deep sternal wound infection and one for leg wound infection). Mean post-operative stay was 8.2±5.8 days and mean ICU stay was 1.6±1.1 days. There were three late deaths—two were due to progression of the hematologic disease. The 3-year actuarial survival was 83%. Conclusions: Cardiac operations can be performed with acceptable mortality but significant morbidity rates in patients with hematologic malignancies. Bleeding and infectious complications are most frequently seen and usually lead to reoperations. These findings warrant caution during patient selection.

Key Words: Surgery • Cardiac • Coronary artery disease • Malignancies • Hematologic • Leukemia • Lymphoma • Complications