Mali Shahriar, Sarebanhassanabadi Mohammadtaghi
Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Ethiop J Health Sci. 2016 May;26(3):285-8. doi: 10.4314/ejhs.v26i3.11.
Combined open-heart surgery and thyroidectomy is a rare procedure. However, some difficulties will occur for cardiac surgery when thyromegaly extends into the retrosternal space.
A 54-year-old woman suffering from dyspnea, chest pain and decreased left ventricular function (EF=40%) was diagnosed with coronary artery disease (3 vessel disease) and became candidate for coronary artery bypass grafting (CABG). Also, she had multinodular goiter with normal thyroid function test. After midsternotomy, a huge goiter was seen in the upper mediastinum. Because the mass had covered the ascending aorta and involved the posterior aspect of the innominate vein making access to aorta impossible, thyroidectomy was performed at first followed by CABG. Post-operation course was satisfactory. Fourteen months later, the patient was euthyroid and in NYHA class 1.
The evidence of the case showed that combined CABG and thyroidectomy can be performed safely.
心脏直视手术与甲状腺切除术联合进行是一种罕见的手术。然而，当甲状腺肿大延伸至胸骨后间隙时，心脏手术会出现一些困难。
一名54岁女性，有呼吸困难、胸痛症状，左心室功能下降（射血分数[EF]=40%），被诊断为冠心病（三支血管病变），成为冠状动脉旁路移植术（CABG）的候选者。此外，她患有多结节性甲状腺肿，甲状腺功能检查正常。正中胸骨切开术后，上纵隔可见巨大甲状腺肿。由于肿块覆盖升主动脉并累及无名静脉后侧，无法进入主动脉，因此先进行甲状腺切除术，随后进行CABG。术后过程顺利。14个月后，患者甲状腺功能正常，纽约心脏协会（NYHA）心功能分级为I级。
该病例证据表明，CABG与甲状腺切除术联合进行可安全实施。
