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[Coronary artery bypass grafting for a patient with hypothyroidism--a case report]
1Second Department of Surgery, Shiga University of Medical Science, Japan.
Insights
Hypothyroidism can alter aortic wall structure, leading to bleeding complications during cardiac surgery. Avoiding aortic procedures in hypothyroid patients may prevent adverse events.
Area of Science:
- Cardiovascular Surgery
- Endocrinology
- Vascular Histopathology
Background:
- A 59-year-old female with hypothyroidism presented with angina pectoris.
- The patient underwent aorto-coronary bypass grafting for coronary artery disease.
Observation:
- Unexpected bleeding occurred from the ascending aorta suture line during sternal closure.
- Histological examination of the aortic wall was performed.
Findings:
- The aortic wall showed sparse and disrupted elastic fibers.
- Mucopolysaccharide deposition was observed in the aortic wall.
- No atheromatous changes were identified.
Implications:
- Hypothyroidism can induce significant histological changes in the aortic wall.
- Surgical interventions on the aorta in hypothyroid patients carry increased risks.
- Minimizing aortic procedures in patients with hypothyroidism is recommended to prevent bleeding complications.
Abstract:
A 59-year-old female who had been treated for hypothyroidism was admitted with angina pectoris and underwent aorto-coronary bypass grafting. On closing of the sternum, there was unexpected bleeding from the suture line between the vein graft and the ascending aorta. Histological examination of the aortic wall revealed sparsity and disruption of elastic fibers and deposition of mucopolysaccharide without any findings of atheromatous change. It is concluded that hypothyroidism can cause histological change of the aortic wall and that surgical procedures involving the aortic wall in patient with hypothyroidism should be avoided if possible.