OPCAB and thyroidectomy in a patient with a severely compromised airway

Mehta, Yatin; Sujatha, P; Juneja, Rajiv; Singh, Harinder; Sachdeva, Shilpa; Trehan, Naresh

doi:10.1053/j.jvca.2004.11.015

Cited by 8 publications

(12 citation statements)

References 8 publications

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“…1) As in our patient, the risk of MI is high in patients with recent MI and/or poor ventricular dysfunction.…”

Section: Commentssupporting

confidence: 54%

“…Concomitant surgery for substernal giant goiter and CAD has only been reported by a few researchers in the English literature as far as we know. 1,2) In all cases, including ours, thyroidectomy was performed first with a combination of collar incision and median sternotomy. Dissection of the substernal goiter is often difficult due to the compression to the adjacent mediastinal structures and hemorrhagic degeneration of the goiter.…”

Section: Commentsmentioning

confidence: 95%

“…The risk of MI is as high as 40% if the grafts are injured at the time of sternal re-entry. 1) Moreover, with the second sternotomy for CABG there is increased scar formation from the previous sternotomy, which can make dissection of the goiter from other mediastinal structures more difficult than would be with a primary thyroidectomy. Another consideration is sudden swelling of the goiter.…”

Section: Commentsmentioning

confidence: 99%

“…1) Persistent upper airway obstruction due to substernal goiter may increase stress to the cardiovascular system and also increase the risk of the coronary artery disease (CAD).…”

Section: Introductionmentioning

confidence: 99%

“…1) Here, we report a patient who presented with acute myocardial infarction (MI) and was found to have a giant substernal goiter with compressive symptoms. The patient underwent single-stage surgery combining thyroidectomy and coronary artery bypass grafting (CABG).…”

Section: Introductionmentioning

confidence: 99%

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Single-stage Operation for Giant Substernal Goiter with Severe Coronary Artery Disease

Wexler

Yamane

Fisher

et al. 2011

ATCS

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A 76-year-old female, with a history of asthma and tracheal bronchitis, presented with a non-ST elevation, myocardial infarction. Chest x-ray on admission showed a widened mediastinum, which was further evaluated with a computed tomography (CT) scan. It disclosed a giant substernal goiter compressing the trachea and the ascending aorta. Cardiac catheterization showed significant coronary disease unsuitable for percutaneous intervention; thus, the patient was scheduled for coronary artery bypass grafting. Single stage thyroidectomy immediately followed by coronary artery bypass was performed. After surgery, her upper airway symptoms were improved, and no cardiac events were noted. Collaboration between otolaryngology and thoracic surgery teams contributed to good outcomes for this patient with substernal goiter and severe cardiac disease.

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“…1) As in our patient, the risk of MI is high in patients with recent MI and/or poor ventricular dysfunction.…”

Section: Commentssupporting

confidence: 54%

Section: Commentsmentioning

confidence: 95%

Section: Commentsmentioning

confidence: 99%

“…1) Persistent upper airway obstruction due to substernal goiter may increase stress to the cardiovascular system and also increase the risk of the coronary artery disease (CAD).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Single-stage Operation for Giant Substernal Goiter with Severe Coronary Artery Disease

Wexler

Yamane

Fisher

et al. 2011

ATCS

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Combined Off-pump Coronary Artery Bypass Grafting and Thyroidectomy

Mehra

Shah

Jain

et al. 2009

The Annals of Thoracic Surgery

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Does a combined procedure for cardiac surgery and thyroidectomy offer acceptable outcomes?

Silva

Dignan

2015

Interactive CardioVascular and Thoracic Surgery

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This best evidence topic on cardiothoracic surgery was written using a structured protocol. The question addressed was: 'in an adult patient requiring cardiac surgery, can a thyroidectomy for a large retrosternal goitre be performed with good outcomes as a combined procedure?' Of 150 papers identified through the literature search, 16 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, study type, patient group studied, relevant outcomes and results were tabulated. This paper includes 3 Level 4 papers and 13 case reports. All papers reported postoperative outcomes and five papers reported intraoperative outcomes. Of a total cohort of 32 patients, 25 were euthyroid prior to combined surgery. Twenty-nine of 32 thyroid surgeries were performed immediately prior to cardiac surgery in the combined procedure sequence. Post-procedural complications including transient recurrent laryngeal palsy and tracheomalacia were reported in 8 patients. There was one intraoperative death. Where reported, all patients were euthyroid on follow-up. All identified papers reported good outcomes with combined thyroidectomy and cardiac surgery.

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OPCAB and thyroidectomy in a patient with a severely compromised airway

Cited by 8 publications

References 8 publications

Single-stage Operation for Giant Substernal Goiter with Severe Coronary Artery Disease

Single-stage Operation for Giant Substernal Goiter with Severe Coronary Artery Disease

Combined Off-pump Coronary Artery Bypass Grafting and Thyroidectomy

Does a combined procedure for cardiac surgery and thyroidectomy offer acceptable outcomes?

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