Our Summary

The research aims to find out if having a past cardiothoracic surgery could have an effect on the outcome of a lung transplant. The study analyzed data from the United Network for Organ Sharing from 2005 to 2019. They looked at adult patients who had lung transplants and had previously had heart or chest surgeries.

The study found that out of 24,784 lung transplants, 2.7% had a previous heart surgery and 6.5% had a previous chest surgery. The death rate during surgery was higher for patients who had previous heart surgery (6.1%) compared to those who did not (3.1%). The same was true for those who had previous chest surgery (4.9%) compared to those who did not (3.1%).

Patients who had previous chest surgery also had more cases of the transplanted lung not working properly and cases of the body rejecting the new lung in the first year after the transplant. However, there were no differences found in patients having a stroke, needing dialysis, requiring a breathing tube, or needing a machine to help their heart and lungs work 72 hours after surgery.

Long-term survival was significantly worse for lung transplant patients who had a previous heart surgery (they lived a median of 3.8 years compared to 6.3 years), due to an increase in deaths from heart issues and cancer. However, having a previous chest surgery did not affect long-term survival (6.6 years vs 6.1 years).

In conclusion, having a previous heart surgery before a lung transplant results in lower survival rates due to heart problems and cancer. Having a previous chest surgery worsens the outcomes immediately after surgery, but does not affect how long patients live after the transplant.

FAQs

  1. Does having previous cardiothoracic surgery affect the outcome of a lung transplant?
  2. What are the long-term survival rates for lung transplant patients who have had previous cardiac surgery?
  3. How does previous thoracic surgery affect perioperative outcomes and long-term survival rates in lung transplant patients?

Doctor’s Tip

One helpful tip a doctor might tell a patient about cardiac surgery is to carefully follow post-operative instructions, including taking medications as prescribed, attending follow-up appointments, and participating in cardiac rehabilitation programs to aid in recovery and improve long-term outcomes. It is important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients who are typically recommended for cardiac surgery include those with coronary artery disease, heart valve disease, congenital heart defects, and other heart conditions that cannot be effectively treated with medication or less invasive procedures. These patients may experience symptoms such as chest pain, shortness of breath, fatigue, and heart palpitations that significantly impact their quality of life. Additionally, patients who have had previous cardiac surgery and subsequently require lung transplant may also be recommended for cardiac surgery to address any ongoing heart issues and optimize their overall health before undergoing the transplant procedure.

Timeline

Before cardiac surgery:

  1. Patient is diagnosed with a cardiac condition that requires surgical intervention.
  2. Patient undergoes pre-operative testing and evaluation to assess their overall health and readiness for surgery.
  3. Patient discusses the risks and benefits of surgery with their healthcare team and makes a decision to proceed with surgery.
  4. Patient is admitted to the hospital on the day of surgery and undergoes anesthesia induction.
  5. Cardiac surgery is performed, which may include procedures such as coronary artery bypass grafting, valve replacement, or repair.
  6. Patient is transferred to the intensive care unit for post-operative monitoring and care.

After cardiac surgery:

  1. Patient is closely monitored in the intensive care unit for complications such as bleeding, infection, and arrhythmias.
  2. Patient is gradually weaned off of mechanical ventilation and other supportive measures as they recover.
  3. Patient begins physical therapy and rehabilitation to regain strength and mobility.
  4. Patient is discharged from the hospital once they are stable and able to care for themselves at home.
  5. Patient continues to follow up with their healthcare team for post-operative appointments and monitoring of their heart health.
  6. Patient may need to make lifestyle changes, such as diet and exercise, to maintain their heart health and prevent future cardiac events.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with having cardiac surgery prior to lung transplant?
  2. How will my previous cardiac surgery impact the success of the lung transplant surgery?
  3. Will my previous cardiac surgery affect my recovery time and overall outcome after lung transplant?
  4. Are there any specific precautions or considerations that need to be taken during the lung transplant surgery due to my previous cardiac surgery?
  5. How will my long-term survival be affected by having had previous cardiac surgery before the lung transplant?
  6. What steps can be taken to minimize the risks and improve the outcomes for lung transplant patients with a history of cardiac surgery?
  7. Are there any lifestyle changes or medications that I should consider post-transplant to reduce the impact of my previous cardiac surgery on my overall health?
  8. Will I need additional monitoring or follow-up care due to my history of cardiac surgery before the lung transplant?
  9. Are there any specific warning signs or symptoms that I should watch out for post-transplant, given my previous cardiac surgery?
  10. Are there any alternative treatment options or considerations for lung transplant patients with a history of cardiac surgery?

Reference

Authors: Schumer EM, Saddoughi SA, Spencer PJ, Pochettino A, Daly RC, Villavicencio MA. Journal: Eur J Cardiothorac Surg. 2022 Sep 2;62(4):ezac437. doi: 10.1093/ejcts/ezac437. PMID: 36029251