Onoe M, Magara T, Yamamoto Y, Nojima T
Department of Cardiac Surgery, Shiga Medical Center for Adults, Shiga, Japan.
Kyobu Geka. 1998 Mar;51(5):388-91.
Since open heart surgery may cause thyrotoxic crisis during the perioperative period in patients with hyperthyroidism, close monitoring and control are needed. We performed open heart surgery in 2 patients with hyperthyroidism, and good results were obtained. A 71-year-old patient with mitral valve insufficiency underwent mitral valve repair by replacement of chordae tendineae with polytetrafluoroethylene sutures and annuloplasty with a Duran's Ring. The other 20-year-old patient with aortic valve insufficiency underwent aortic valve replacement with an SJM valve. In the two patients, cardiopulmonary bypass for a prolonged period was required during surgery. However, thyrotoxic crisis could be prevented by controlling thyroid function by preoperative treatment with anti-thyroid agents, concurrent medication with Lugol's iodine solution immediately before surgery and re-administration of anti-thyroid agents early after surgery.
由于心脏直视手术可能会在甲状腺功能亢进患者的围手术期引发甲状腺毒症危象，因此需要密切监测和控制。我们对2例甲状腺功能亢进患者进行了心脏直视手术，并取得了良好的效果。一名71岁二尖瓣关闭不全患者采用聚四氟乙烯缝线置换腱索及使用杜兰环进行瓣环成形术来修复二尖瓣。另一名20岁主动脉瓣关闭不全患者使用SJM瓣膜进行主动脉瓣置换。在这两名患者中，手术期间需要长时间的体外循环。然而，通过术前使用抗甲状腺药物控制甲状腺功能、术前即刻同时服用卢戈氏碘溶液以及术后早期再次给予抗甲状腺药物，可预防甲状腺毒症危象。
