Surgical results and perioperative complications in patients presenting lung cancer and cardiovascular diseases

Among 525 patients with lung cancer who underwent an operation between 1985 and 1998, 24 patients who also had a cardiovascular disease, most commonly ischemic heart disease. We gave all of these patients a preoperative assessment for ischemic heart disease, done according to a diagnostic flow chart. Eighteen patients (3.4%) were found to have IHD. We performed myocardial revascularization before or simultaneously with an operation for lung cancer in patients who also have known IHD. None of these patients had major perioperative cardiac trouble. Inspite of our efforts, perioperative myocardial ischemic events occurred in 6 patients (1.2% of all patients) who were not detected by our preoperative IHD assessment. We conclude that this IHD assessment flow chart may be useful for proper perioperative management of patients undergoing lung surgery. However, more precise methods to detect patients with IHD will be necessary to improve their perioperative cardiac risk.