Coronary artery bypass grafting in patient with malignant neoplasm. Efficacy of coronary artery bypass grafting on beating heart.

OBJECTIVE: Coronary artery bypass grafting (CABG) prior to noncardiac major surgery has effectively decreases short- and long-term mortality related to coronary ischemia. Coronary artery bypass on the beating heart is conducted to avoid the risk of cardiopulmonary bypass and it has contribute to shorten recovery time.
METHODS: Subjects were 19 patients with malignant neoplasm for whom a retrospective chart review was made between Jan. 1, 1992 and July 31, 1998. In the early phase of this study, between Jan. 1, 1992, and Dec. 31, 1997, CABG was performed using cardiopulmonary bypass, and late phase, between Jan. 1, 1998, and July 1, 1998, CABG was done on the beating heart without cardiopulmonary bypass.
RESULTS: Conventional CABG was performed in 12 patients with neoplasms (10 male and 2 female, age 64.7 +/- 6.1 years), and CABG on the beating heart was performed in 7 patients (6 male and 1 female, age 68.0 +/- 7.5 years). Fewer number of bypass grafts were made in the beating-heart CABG group (1.3 +/- 0.5 in beating-heart CABG versus 3.9 +/- 1.1 in conventional CABG). No cardiac events occurred in either group during the surgery for malignant tumors. The operative interval between CABG and cancer surgery was significantly shorter in the beating-heart CABG group (21.8 +/- 17.9 days in beating-heart CABG versus 53.5 +/- 42.9 days in conventional CABG, p < 0.05).
CONCLUSION: Patients with severe coronary artery disease and malignant neoplasms should undergo coronary artery revascularization before the neoplasm is treated. CABG on the beating-heart was safe and effective procedure in those with malignant neoplasms.