A coronary artery bypass operation was performed successfully on a 70-
year-old patient who had undergone left pneumonectomy 40 years earlier
. This case, together with a search of the literature and a mail surve
y among 118 cardiothoracic surgeons worldwide, yielded data on 27 such
patients for review. Two patients died perioperatively. Three patient
s had pneumothorax, and 1 patient had recurrent pleural effusion. Diff
iculty in exposing the circumflex marginal branches was reported in 2
patients after left pneumonectomy. We conclude that with attention to
the specific features of the preoperative, intraoperative, and postope
rative management, open heart procedures can be performed on patients
after pneumonectomy with acceptable operative mortality and morbidity.