5. 悪性腫瘍合併症例と周術期管理

Cardiac and Aortic Surgery and Perioperative Management in Patients with Malignant Tumors

近年生活習慣の変化や高齢化に伴い，心血管疾患を有する高齢者が悪性腫瘍に罹患する機会が増加することが予想される．事実，日本人の死亡原因第1位は長らく悪性腫瘍が占めているが，心臓血管疾患による死亡も年々増加し，過去20年近く死因の第2位を占めている1）．したがってわれわれ外科も含めた循環器疾患に携わる医療者にとって，両疾患を合併した症例を治療する機会は確実に増加すると思われる．

Managing patients with concurrent malignant neoplasms and cardiovascular disease is an important issue, especially with aging populations；however, the optimal treatment strategy in these patients remains controversial. We report 27 patients with simultaneous cardiac and malignant disease in our institution over the past 12 years；23 patients underwent cardiovascular surgery, 4 patients underwent cardiovascular surgery after treatment for malignant disease, and 3 patients died of malignant disease. The treatment strategy for patients with concurrent cardiac and malignant disease should be chosen according to the severity of the cardiovascular disease and the expected prognosis of the malignant disease.