我们的心脏直视手术在活动性肿瘤疾病存在的早期和长期结果

M. Toker, Cüneyt Arkan, A. Taşçı, E. Polat, Üzeyi̇r Yilmaz, Tunahan Sari, Ömer Faruk Akardere
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引用次数: 0

摘要

目的:活动性癌症和心脏病具有相似的环境和生物学特征,可同时发生。当有指征时,这些患者可能需要进行心脏直视手术。本研究的目的是证明早期和长期的结果,并讨论不同类型的活动性恶性肿瘤患者的干预策略,谁接受了心脏直视手术。患者和方法:2012年1月至2020年5月,对10例活动性恶性肿瘤患者进行了心内直视手术。平均年龄65.5岁(52 ~ 77岁),女性4例。2例因晚期胸腔积液急诊手术。4例肺癌行AVR+CABG、CABG、CABG+左上叶切除术和AVR+MVR;1例结肠癌行AVR+CABG;有以下情况之一的4例患者均行CABG:淋巴瘤、乳腺癌、原发性血小板增多症、脑膜瘤;并对1例骨肉瘤患者行左心房、左心室大块切除手术。结果:8例患者出院,2例患者术后早期死亡。术后左偏瘫1例。6个月、1年和5年生存率分别为79%、37.5%和25%。结论:对有活动性肿瘤的高危患者,在死亡率和发病率可接受的情况下,可以成功进行心脏直视手术。我们认为,在经皮冠状动脉介入治疗和/或TAVI不合适的情况下,对于多支冠状动脉疾病、冠状动脉狭窄+主动脉狭窄以及需要双瓣膜置换术的患者,应谨慎选择患者进行手术干预。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early and Long Term Results of Our Open Heart Surgical Operations in the Presence of Active Oncological Diseases
Objectives: Active cancer and heart disease, which share similar environmental and biological characteristics, can occur concomitantly. Open heart surgery may be required for these patients when indicated. The aim of this study is to demonstrate the early and long-term results and discuss the intervention strategy in patients with different types of active malignancies, who underwent open heart surgery. Patients and Methods: Between January 2012 and May 2020, open heart surgery was performed on 10 patients with active malignancies. The mean age was 65.5 (52–77), and 4 of the patients were female. 2 patients were operated emergently due to advanced pleural effusion. AVR+CABG, CABG, CABG+left upper lobectomy and AVR+MVR were performed in 4 patients with lung cancer; AVR+CABG were performed in 1 patient with colon cancer; CABG was performed in 4 patients each with one of the following conditions: lymphoma, breast cancer, essential thrombocytosis, meningioma); and mass resection operation from the left atrium and left ventricle was performed in one patient with osteosarcoma. Results: 8 patients were discharged and 2 patients died in the early postoperative period. Postoperative left hemiparesis developed in 1 patient. 6-month, 1-year and 5-year survival rates were 79%, 37.5% and 25%, respectively. Conclusion: Open heart surgery can be successfully performed with acceptable mortality and morbidity rates on the high-risk patient group with active cancer. We believe that, where percutaneous coronary intervention and/or TAVI are not considered or deemed appropriate, surgical intervention should be performed with careful patient selection in patients with multi-vessel coronary artery disease, coronary artery stenosis +aortic stenosis, and in cases requiring double valve replacement.
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