Cetin Erdem, Ozyuksel Arda, Dalbasi Erkan
Department of Cardiovascular Surgery, Memorial Hospital, Diyarbakir, Turkey.
BMJ Case Rep. 2014 Apr 10;2014:bcr2013201496. doi: 10.1136/bcr-2013-201496.
It 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.
甲状腺疾病与冠状动脉疾病并存的情况较为罕见，其手术治疗可同时进行。在此，我们报告一例胸骨后甲状腺切除术与非体外循环冠状动脉旁路移植术同时进行的病例。一名57岁女性患者因劳力性呼吸困难、间歇性咳嗽和稳定型心绞痛入院。胸骨后甲状腺肿大小为5×5×4 cm，同时左前降支动脉有95%的支架内再狭窄。甲状腺切除术和非体外循环冠状动脉旁路移植术同时进行。术后恢复顺利，患者术后5天出院。该病例表明，在需要对甲状腺和冠状动脉疾病进行手术干预的情况下，非体外循环血管重建似乎是比体外循环血管重建更好的选择，因为后者会考虑体外循环的不良反应。
