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Eur J Cardiothorac Surg 2001;20:1273
© 2001 Elsevier Science NL

Letter to the Editor

Coronary artery bypass grafting after pneumonectomy

Good Samaritan Regional Health Centre, Mount Vernon, IL 62864, USA

Received 20 June 2001; accepted 27 August 2001.

Key Words: Coronary artery bypass graft • Pneumonectomy

I read with interest the case report by Diab [1]. The authors should be congratulated on a successful outcome in a difficult patient. The report, however, lacks specific information in the clinical presentation, which would be extremely important to the reader. The underlying etiology for the pneumonectomy was not given. If done for carcinoma, a computed tomography (CT) scan would give added information given the six-year history. Information from the CT scan and the Echo, which was done, would give better information regarding anatomy of the heart. Berrizbeitia [2], in a very detailed case report, points out specific operative findings which might have been anticipated from a more detailed preoperative anatomical evaluation. Pulmonary function evaluation might have included diffusion capacity for carbon monoxide [3]. The operative findings are not discussed in the terms of locations of the lung, obliteration of the pneumonectomy pace, rotation of the heart and the locations of the aorta and right atrium, especially in its relation to the inferior vena cava. The number of grafts are not mentioned. Clearly if only one or two vein grafts on the anterior surface of the heart were done, a case for off-pump coronary artery bypass could be made. The use of the internal mammary artery (IMA) is important. The hyper-expanded lung and the fear of damage to the phrenic might preclude its use, however, a free IMA graft is certainly an option. In summary, I think the case report could have been strengthened with more clinical information.

References

1. Diab K.A., Khatib M.F., Obeid M., Jamaleddine G.W. Coronary artery bypass grafting after pneumonectomy. Case Report. Eur J Cardiothoracic Surg 2001;19:362-364.
2. Berrizbeitia L.D., Anderson W.A., Laub G.W., McGrath L.B. Coronary artery bypass grafting after pneumonectomy. Ann Thorac-Surg 1994;58:1538-1540.[Abstract]
3. Wang J., Olak J., Ferguson M.K. Diffusing capacity predicts operative mortality but not long-term survival after resection for lung cancer. J Thorac Cardiovasc Surg 1999;117:581-587.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted 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 Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Pezzella, A. T. Search for Related Content PubMed PubMed Citation Articles by Pezzella, A. T. Related Collections Coronary disease