STAGE TREATMENT OF CARDIAC SURGICAL PATIENTS WITH AN IDENTIFIED ONCOLOGICAL PATHOLOGY. CLINICAL CASES

The problem of treating patients suffering from severe cardiovascular diseases and tumors of various locations remains unsolved in oncology. Even specialists from multidisciplinary centers encounter difficulties, the main of which are: deciding on simultaneous or staged treatment, determining the staging of interventions, the timing of their implementation, preoperative preparation and treatment in the postoperative period. For the most part, the category of patients of senile age is presented, with a considerable set of concomitant chronic and acute diseases of varying degrees of compensation. A significant number of cancer patients suffering from severe cardiovascular disease are treated in our multidisciplinary center. In this connection, we would like to share some experience in this area. Two clinical cases are presented in the article: treatment of a patient with a stenotic tumor of the sigmoid colon against the background of acute infectious endocarditis and the next treatment of a patient with malignant colon, aortic valve disease and stenosing lesion of the brachiocephalic arteries. In the first clinical case, the patient revealed infectious endocarditis, then a tumor of the sigmoid colon. The patient underwent a course of systemic antibacterial therapy, after which he underwent resection of the sigmoid colon. After eighteen days, the cardiac surgery stage was performed prosthetics of the aortic and mitral valves. The second clinical case describes the treatment of a patient who has identified indications for surgical correction of severe aortic stenosis. During treatment, atherosclerosis of the brachiocephalic arteries and a tumor of the ascending colon were revealed. By the decision of the interdisciplinary consultation of the patient, stenting of the carotid artery was performed, then transcatheter implantation of the aortic valve followed by right-sided hemicolectomy. Both cases were an example of successfully chosen tactics, as evidenced by the data of long-term postoperative oncological and cardiological follow-up.

tumor of the sigmoid colon, colon tumor, infectious endocarditis, aortic stenosis, stenosis of the brachiocephalic arteries, staged surgical treatment