Original article
General thoracic
Lung Transplantation and Coronary Artery Disease

https://doi.org/10.1016/j.athoracsur.2011.04.021Get rights and content

Background

Coronary artery disease (CAD) remains a relative contraindication to lung transplantation. We have offered lung transplantation and coronary revascularization to selected patients with discrete CAD and preserved left ventricular function. The purpose of this report is the following: (1) to examine the short-term and medium-term outcome of patients after coronary revascularization and lung 3transplantation; and (2) to compare the short-term and medium-term outcome of this cohort to a matched group of lung transplant recipients without CAD.

Methods

From January 2000 to March 2010, 27 patients with CAD underwent coronary revascularization and lung transplantation. The control group was matched based on age, diagnosis, lung allocation score, and type of procedure.

Results

Lung transplant recipients with CAD and the control group had similar incidence of primary graft dysfunction (grade III). The duration of mechanical ventilation, intensive care unit stay, and hospital stay were the same. At a mean follow-up of 3 years, the incidence of composite adverse cardiac events was similar in the 2 groups.

Conclusions

Lung transplant recipients with CAD and the control group also had similar medium-term survival. Lung transplantation can be considered in patients with preexistent CAD with acceptable early and medium-term outcomes.

Section snippets

Patients and Methods

This study was approved by the Institutional Review Board. The records of all patients who underwent lung transplantation at the University of California-Los Angeles from January 2000 to March 2010 were reviewed. During this period, 27 patients underwent lung transplantation and coronary revascularization and are the subject of this study.

Perioperative Characteristics of Patients With CAD and the Control Group

During the study period, 27 patients with critical coronary artery lesions and preserved left ventricular function underwent lung transplantation and coronary revascularization, and are therefore the subjects of this study. The perioperative characteristics of this group of patients are shown in Table 1. The waiting time for patients with CAD and the control group was similar. Thirteen of 27 patients were deemed suitable candidates for single lung transplantation and were therefore referred for

Comment

The findings of this study demonstrate that selected patients with CAD can undergo coronary revascularization and lung transplantation with acceptable short-term and medium- term outcomes. Our results are comparable with lung transplant recipients without CAD.

Several reports have examined the role of coronary revascularization in lung transplant recipients with CAD [7, 8, 9, 10]. Snell and colleagues [7] were the first group to report on 5 patients with clinically significant CAD who underwent

Cited by (0)

View full text