Wexler Sonya, Yamane Kentaro, Fisher Kyle W, Diehl James T, Hirose Hitoshi
The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
Ann Thorac Cardiovasc Surg. 2011;17(5):524-7. doi: 10.5761/atcs.cr.10.01628. Epub 2011 Jul 13.
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.
一名76岁女性，有哮喘和气管支气管炎病史，因非ST段抬高型心肌梗死入院。入院时胸部X线显示纵隔增宽，随后通过计算机断层扫描（CT）进一步评估。结果显示一个巨大的胸骨后甲状腺肿压迫气管和升主动脉。心脏导管检查显示有严重冠状动脉疾病，不适合进行经皮介入治疗；因此，该患者被安排进行冠状动脉搭桥手术。先进行了一期甲状腺切除术，紧接着进行冠状动脉搭桥手术。术后，她的上呼吸道症状得到改善，未发生心脏事件。耳鼻喉科和胸外科团队的合作使这位患有胸骨后甲状腺肿和严重心脏病的患者取得了良好的治疗效果。
