Concomitance of pulmonary carcinoma and heart disease poses problems of management. We encountered this disease combination in 6 of 2,139 patients operated on with extracorporeal circulation during a 5-year period. Our policy has been to correct the heart disease first. The tumour was subsequently operated on in five of the six patients, but the sixth was subjected only to excisional biopsy of malignant tumour nodules during the heart operation. There was no operative mortality. Three patients died in the follow-up period. A treatment strategy is suggested, based on our experience and on a review of the literature.