Prior and Perioperative Revascularization Does Not Affect Survival in Lung Transplant Patients

Jay Kanaparthi, Mohammed A. Kashem, Manish Suryapalam, Huaqing Zhao, Stacey Brann, Eros Leotta, Kenji Minakata, Suresh Keshavamurthy, Norihisa Shigemura, Yoshiya Toyoda

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: Coronary artery disease is common in lung transplant patients and has historically been viewed as a contraindication to the procedure. Although this mindset is changing, the effect of prior or perioperative revascularization on lung transplant survival outcomes is not adequately established. Methods: We performed a single-center retrospective analysis of all single and double lung transplant patients from 2012 to 2018 (n = 468). Patients were split into 4 groups: (1) patients who received a preoperative percutaneous coronary intervention (n = 34), (2) those who received coronary artery bypass grafting (CABG) before transplantation (n = 25), (3) those that received concomitant CABG during transplantation (n = 29), and (4) those who had lung transplantation with no need for revascularization (n = 380). Groups were compared for demographics, surgical procedure, and survival outcomes. Results: The no-revascularization group was statistically younger than the rest (P = .001). The lung allocation score trended toward being higher in the concomitant coronary artery bypass group (P = .03). All groups were predominantly diagnosed with idiopathic pulmonary fibrosis. The proportion of patients with chronic obstructive pulmonary disease was greatest in the group not requiring revascularization (P = .001). Patients with previous CABG were more likely to receive a single lung transplant than a double one (21 versus 4; P = .054). Length of stay, posttransplant survival, and postoperative adverse events were similar among all groups. Conclusions: Results suggest that preoperative or intraoperative revascularization does not negatively affect survival in lung transplant patients; lung recipients with coronary artery disease have comparable survival when adequately revascularized.

Original languageEnglish
Pages (from-to)1677-1683
Number of pages7
JournalAnnals of Thoracic Surgery
Issue number6
StatePublished - Jun 2020

Bibliographical note

Publisher Copyright:
© 2020 The Society of Thoracic Surgeons

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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