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

Wexler, Sonya J.; Yamane, Kentaro; Fisher, Kyle; Diehl, James T.; Hirose, Hitoshi

doi:10.5761/atcs.cr.10.01628

Cited by 12 publications

(10 citation statements)

References 9 publications

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“…Simultaneous surgery for cardiac and thyroid diseases has been encouraged recently 2 3. A coordinated preoperative assesment should be performed in such patients by the endocrinologists and the surgeons before the operation.…”

Section: Discussionmentioning

confidence: 99%

“…There is still no consensus on the sequence of procedures (thyroidectomy or CABG) and usage of cardiopulmonary bypass (CPB; off-pump or on-pump). Wexler et al 2 performed thyroidectomy first, followed by on-pump CABG in a patient with diabetes, obesity, asthma and low ejection fraction (29%) in whom adverse effects of CPB may alter the operative and postoperative courses such as extubation time, intensive care unit stay and total period of hospitalisation. Mehra et al 5 performed OPCAB first in the acute setting of myocardial infarction in a 70-year-old patient with left main coronary artery stenosis and an SG leading to tracheal compression.…”

Section: Discussionmentioning

confidence: 99%

“…Even though cardiac surgery with concomitant thyroidectomy is considered to be a safe procedure, these operations are rarely reported in the literature 2 3. Similarly, off-pump coronary artery bypass grafting (OPCAB) with simultaneous thyroidectomy has been reported only in two cases within the PubMed repository 4 5.…”

Section: Introductionmentioning

confidence: 99%

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Single stage substernal thyroidectomy and off-pump coronary artery bypass grafting: is it worth using cardiopulmonary bypass unless absolutely necessary?

2014

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SUMMARYIt is a rare entity to observe the coexistence of thyroid gland pathologies and coronary artery disease, whose surgical treatment may be performed simultaneously. In this case, we present a case of a patient with substernal thyroidectomy concurrent with off-pump coronary artery bypass grafting. A 57-year-old female patient was admitted to the hospital with exertional dyspnoea, intermittent coughing and stable angina pectoris. The substernal goitre measuring 5×5×4 cm was accompanied by a 95% in-stent restenosis at the left anterior descending artery. Thyroidectomy and off-pump coronary artery bypass grafting procedures were performed simultaneously. The postoperative period was uneventful and the patient was discharged 5 days after the operation. This case indicates that off-pump revascularisation seems to be a better option in cases where surgical interventions for thyroid and coronary artery diseases are necessary instead of on-pump revascularisation where the adverse effects of the cardiopulmonary bypass are considered. BACKGROUND

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Single stage substernal thyroidectomy and off-pump coronary artery bypass grafting: is it worth using cardiopulmonary bypass unless absolutely necessary?

2014

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“…These were mostly reports of an individual case [1][2][3][4][5][6][7][8][9][10][11][12] and a few small case series [13][14][15]. In majority of cases, thyroidectomy was performed due to Retrosternal extension or tracheal compression was the main reason why thyroidectomy was performed together with CABG.…”

Section: Indication For Thyroidectomymentioning

confidence: 99%

Combined Total Thyroidectomy and Coronary Artery Bypass Grafting: An Endocrine Surgeon Perspective

Aripin¹,

Osman²,

Othman³

et al. 2018

J Univer Surg

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“…[1][2][3][4][5][6] Patient age ranged from 55 to 79, with a mean age of 69 years. Five patients were males and four females.…”

Section: Discussionmentioning

confidence: 99%

Combining Thyroidectomy with Cardiac Surgery: Implications for the Endocrine Surgeon

Daniel¹,

Lansdown²

2012

World Journal of Endocrine Surgery

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The management of incidentally detected retrosternal goiter in patients with cardiac disease awaiting open heart surgery is controversial. Here, we present the case of a 79-year-old man; who had coronary artery bypass grafting, aortic valve replacement and thyroidectomy for retrosternal goiter under a single anesthetic. A literature search was conducted to study patient demographics, thyroid symptomatology, pathology, complications and the risks and benefits of the combined procedures. Literature search revealed only a few similar cases of a combined surgical approach and these are from the perspective of the cardiac surgeon. The study is presented to highlight the implications of such combined procedures for the endocrine surgeon.A medline search was conducted for combined procedures on heart and thyroid. Five case reports and two reviews, including one case of off-pump coronary artery bypass grafting (CABG) was obtained. The mean age of the patients was 69 years (range, 55-79). Retrosternal goiter was the commonest indication (67%), half of them presenting with tracheal compression. Thyrotoxicosis was observed in 22%. Beinign multinodular goiter was the commonest pathology (89%). There was one case of Grave's disease. There were no reported malignancies. There were no reported complications from the endocrine surgery.The various cardiac procedures in the combined operations were coronary artery bypass grafting, aortic valve replacement, mitral valve replacement, a combination of these and a case of closure of atrial septal defect.The review has looked into the anatomical and physiological implications of combined operations, operative risks and has upheld the safety of such combined procedures.

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

Cited by 12 publications

References 9 publications

Single stage substernal thyroidectomy and off-pump coronary artery bypass grafting: is it worth using cardiopulmonary bypass unless absolutely necessary?

Single stage substernal thyroidectomy and off-pump coronary artery bypass grafting: is it worth using cardiopulmonary bypass unless absolutely necessary?

Combined Total Thyroidectomy and Coronary Artery Bypass Grafting: An Endocrine Surgeon Perspective

Combining Thyroidectomy with Cardiac Surgery: Implications for the Endocrine Surgeon

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