Comparison of the Effectiveness of Coronary Artery Bypass Grafting and Stent Implantation Combined with Surgical Intervention for Lung Neoplasms

Background: Lung cancer is the most common primary malignant lung tumor. Coronary artery disease (CAD) is the leading cause of death worldwide. In clinical practice, cases of lung cancer complicated by CAD are encountered, which are associated with a high risk of mortality.

Materials and methods: This study analyzed the results of examination, treatment, and follow-up of patients who underwent elective surgery from 01.01.2015 to 01.06.2024. All patients were divided into two groups according to the selected myocardial revascularization method:

•  Group 1: patients with lung tumors who underwent simultaneous surgery (coronary artery bypass grafting + lung resection) (71 patients);

•  Group 2: patients with lung tumors who underwent percutaneous coronary intervention with delayed lung surgery (resection or lobectomy) (94 patients).

Results: Early in-hospital complications were observed frequently in patients after coronary artery bypass grafting than after percutaneous coronary intervention: acute heart failure – 9.86% vs 0%, p=0.02; atrial fibrillation – 15.4% vs 0%, p=0.013; sepsis – 8.45% vs 0%, p=0.004; post-hypoxic encephalopathy – 9.86% vs 0%, p=0.002).

Mortality was observed in the coronary artery bypass grafting group (2 patients) and was not recorded in the percutaneous coronary intervention group; however, did not reach statistically significant difference. During long-term follow-up (6 months to 6 years), mortality due to cancer progression was similarly high in both groups, whereas cardiovascular mortality and ischemic events were comparably low in Groups 1 and 2.

Conclusion: The obtained data demonstrate a higher incidence of various complications in the early in-hospital period after coronary artery bypass grafting, which is associated with the greater invasiveness of the method; however, these features do not affect long-term patient survival.

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