Combined Open-Heart Coronary Artery Bypass Surgery and Subtotal Thyroidectomy in a 54-year-old patient: A Case Report

Abstract

BACKGROUND: Combined open-heart surgery and thyroidectomy is a rare procedure. However, some difficulties will occur for cardiac surgery when thyromegaly extends into the retrosternal space. CASE DETAILS: A 54-year-old woman suffering from dyspnea, chest pain and decreased left ventricular function (EF=40%) was diagnosed with coronary artery disease (3 vessel disease) and became candidate for coronary artery bypass grafting (CABG). Also, she had multinodular goiter with normal thyroid function test. After midsternotomy, a huge goiter was seen in the upper mediastinum. Because the mass had covered the ascending aorta and involved the posterior aspect of the innominate vein making access to aorta impossible, thyroidectomy was performed at first followed by CABG. Postoperation course was satisfactory. Fourteen months later, the patient was euthyroid and in NYHA class 1. CONCLUSION: The evidence of the case showed that combined CABG and thyroidectomy can be performed safely.

The evaluation of simultaneous combined surgery of the heart and thyroid - own experience

“…Scientific reports indicate the safety of simultaneous operations on the thyroid gland and coronary artery bypass grafting, inclining at the same time to perform the operation without ECC. This is to reduce the amount of heparin administered -and thus reduce the risk of bleeding [21,22,23] The undoubted downside of simultaneous surgeries is the duration of the procedure. In our case it took about 400 minutes (315-510 minutes) on average, so there is a possibility of excessive cooling of the patient or the occurrence of pressure ulcers.…”

Clinical Characteristics and Predictors Related to the Progression of Multinodular Goiter Causing Tracheal Compression and Deviation: A Report of Two Cases and Review of the Literature

“…1). Twenty publications (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) including 42 patients were reviewed based on the evaluation method summarized in Fig. 1.…”