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J Thorac Cardiovasc Surg 2009;137:1551-1552
© 2009 The American Association for Thoracic Surgery

Brief Communication

Concomitant bilateral lung volume reduction surgery and aortic valve replacement: Multidisciplinary strategies in achieving a successful outcome

Cliff K. Choong, FRCS, FRACSa,b,*, Yasir Abu-Omar, DPhil, MRCSb, Ajit Agarwal, FRCPc, Thomas Pulimood, FRCPd, Nicholas Screaton, FRCRe, Ian Hardy, FRCAf, Alain Vuylsteke, PhD, FRCAf, Michael Davies, FRCPg

a Department of Surgery, The University of Cambridge, Cambridge, United Kingdom
b Department of Cardiothoracic Surgery, Papworth Hospital NHS Trust, Cambridge, United Kingdom
e Department of Radiology, Papworth Hospital NHS Trust, Cambridge, United Kingdom
f Department of Anaesthesia and Intensive Care Unit, Papworth Hospital NHS Trust, Cambridge, United Kingdom
g Department of Respiratory Medicine, Papworth Hospital NHS Trust, Cambridge, United Kingdom
c Department of Cardiology, West Suffolk Hospital NHS Trust, Bury St Edmunds, United Kingdom
d Department of Respiratory Medicine, West Suffolk Hospital NHS Trust, Bury St Edmunds, United Kingdom

* Address for reprints: Cliff K. Choong, FRCS, FRACS, University Lecturer, The University of Cambridge, Consultant Cardiothoracic Surgeon, Papworth Hospital NHS Trust, Cambridge CB23 8RE, United Kingdom. (Email: cliffchoong@hotmail.com).

The first 20% of the full text of this article appears below.

Significant cardiac comorbidity is generally considered a contraindication for lung volume reduction surgery (LVRS). We described a multidisciplinary approach that led to the successful management of a 53-year-old woman with severe aortic stenosis who had a forced expiratory volume in 1 second (FEV1) of 20% predicted secondary to smoking-related end-stage emphysema.

Clinical Summary

A 53-year-old woman was referred for aortic valve replacement (AVR). She had symptomatic (angina and dizzy spells) severe aortic stenosis (aortic valve area 0.8 cm2, echocardiographic peak gradient 93 mm Hg, mean gradient 62 mm Hg), moderate aortic regurgitation, left ventricular hypertrophy, and left ventricular dysfunction. She had poor pulmonary function secondary to severe emphysema (Table 1 ) with marked functional limitation affecting daily activities and necessitating domiciliary oxygen therapy (Table 1). She had stopped smoking 12 months previously, was motivated to improve, and had good family support. Her emphysema was heterogenous in distribution with . . . [Full Text of this Article]




This article has been cited by other articles:


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 J. Thorac. Cardiovasc. Surg.Home page
C. K. Choong, J. Naylor, A. Vuylsteke, I. Hardy, N. Screaton, J. Porter, and M. Davies
Successful combined bilateral lung volume reduction and coronary artery bypass grafting surgery: Implications and advantages.
J. Thorac. Cardiovasc. Surg., June 1, 2009; 137(6): 1552 - 1554.
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