Premium
Postoperative outcomes and management strategies for coronary artery disease in patients in need of a lung transplantation
Author(s) -
Khandhar Sameer J.,
Althouse Andrew D.,
Mulukutla Suresh,
Kormos Robert,
Toma Catalin,
Marroquin Oscar,
Volz Elizabeth,
Tefera Leben,
Bermudez Christian
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13026
Subject(s) - medicine , lung transplantation , coronary artery disease , transplantation , disease , surgery , intensive care medicine , cardiology
Background Patients requiring lung transplantation ( LT x) may also have coronary artery disease ( CAD ). The peri‐operative management and long‐term outcomes of these patients are not well established. Methods Patients referred for LT x from 2008 to 2014 were included in this study. CAD was defined by angiography as no CAD (stenosis <20%), moderate CAD (20%‐69%), and significant CAD (stenosis ≥70%). Revascularization was per recommendations of local heart team. Postoperative cardiovascular outcomes and long‐term survival are reported. Results A total of 1493 patients were screened for LT x during this period and 656 received a transplant. Of the patients that underwent LT x, 51% had no CAD , 33% had moderate non‐obstructive CAD , and 16% had obstructive CAD . Forty‐three patients underwent revascularization. There was a no increased risk of peri‐operative cardiovascular events or for adjusted mortality for patients with obstructive CAD ( HR =1.24, 95% CI : 0.83‐1.86, P =.290) including those requiring revascularization. Conclusions There is a high prevalence of coronary disease in the population of patients with advanced lung disease requiring lung transplantation. Careful evaluation and treatment can allow for patients with all severities of CAD including those requiring revascularization to successfully undergo LT x.