Hasan Zaidi Syed Danish, Khan Muhammad Shahzeb, Bawany Faizan Imran, Dar Mudassir Iqbal, Khan Abdul Bari
Department of Cardiac Surgery, Dow University of Health Sciences, Karachi.
Department of Medical Student, Dow University of Health Sciences, Karachi.
J Coll Physicians Surg Pak. 2014 Nov;24 Suppl 3:S158-60.
A 62 years old patient developed myasthenia gravis 2 years after his percutaneous coronary intervention. He was advised thymectomy for myasthenia gravis. During his cardiological evaluation, he was incidentally diagnosed to have 3 vessel disease. Hence, a simultaneous surgical intervention was performed consisting of thymectomy and CABG via standard cardiopulmonary bypass through median sternotomy. Previous medical history of diabetes and corticosteroid therapy made the patient immunocompromised. Therefore, a careful overall therapeutic strategy was devised to prevent mediastinitis. After his thymectomy and coronary artery bypass grafting, he was extubated within 6 hours. Plasmapheresis was done one day before the surgery and on first postoperative day. His medications for myasthenia gravis (pyridostigmine and prednisolone) were not stopped before and after the surgery. Patient was discharged on 6th postoperative day without any complications. On his follow-up 6 weeks postoperatively, his condition was unremarkable.
