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Management of patients with hematological malignancies undergoing coronary artery bypass grafting


1 Department of Cardiac Anesthesia, P.D. Hinduja National Hospital and Medical Research Centre, Mahim Fortis Hospitals, Mulund, Lilavati Hospital, Bandra, Mumbai, Maharashtra, India
2 Department of Cardiothoracic Surgery, P.D. Hinduja National Hospital and Medical Research Centre, Mahim Fortis Hospitals, Mulund, Lilavati Hospital, Bandra, Mumbai, Maharashtra, India

Correspondence Address:
Deepak Borde
Department of Anesthesia, P.D. Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai -400 016, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.105370

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Year : 2013  |  Volume : 16  |  Issue : 1  |  Page : 47-50

 

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The number of patients with a previously diagnosed malignancy who need cardiac surgery is increasing. Patients with hematological malignancies represent only 0.38% of all patients undergoing cardiac surgery. The literature in this subset of patients is limited to only a few retrospective case series, with limited number of patients undergoing emergency cardiac surgery. We describe three cases with hematological malignancies namely chronic myelogenous leukemia, acute promyelocytic leukemia and chronic lymphocytic leukemia presenting for coronary artery bypass grafting (CABG). Two patients were taken up for emergency CABG in view of ongoing ischemia, one of them was on preoperative intra-aortic balloon pump support. No mortality was observed. Two patients needed transfusion of blood products which was guided by thromboelastography. One patient developed superficial sternal wound infection requiring antibiotic therapy.






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1 Department of Cardiac Anesthesia, P.D. Hinduja National Hospital and Medical Research Centre, Mahim Fortis Hospitals, Mulund, Lilavati Hospital, Bandra, Mumbai, Maharashtra, India
2 Department of Cardiothoracic Surgery, P.D. Hinduja National Hospital and Medical Research Centre, Mahim Fortis Hospitals, Mulund, Lilavati Hospital, Bandra, Mumbai, Maharashtra, India

Correspondence Address:
Deepak Borde
Department of Anesthesia, P.D. Hinduja National Hospital and Medical Research Centre, Mahim, Mumbai -400 016, Maharashtra
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.105370

Rights and Permissions

The number of patients with a previously diagnosed malignancy who need cardiac surgery is increasing. Patients with hematological malignancies represent only 0.38% of all patients undergoing cardiac surgery. The literature in this subset of patients is limited to only a few retrospective case series, with limited number of patients undergoing emergency cardiac surgery. We describe three cases with hematological malignancies namely chronic myelogenous leukemia, acute promyelocytic leukemia and chronic lymphocytic leukemia presenting for coronary artery bypass grafting (CABG). Two patients were taken up for emergency CABG in view of ongoing ischemia, one of them was on preoperative intra-aortic balloon pump support. No mortality was observed. Two patients needed transfusion of blood products which was guided by thromboelastography. One patient developed superficial sternal wound infection requiring antibiotic therapy.






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