Pituitary apoplexy and CABG: should we change our strategy?

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Updated: Jul 11, 2026

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
05:25

Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft

Published on: September 15, 2023

Eli Levy1, Amit Korach, Gideon Merin

  • 1Division of Cardiothoracic Surgery, Hadassah University Hospital, Jerusalem, Israel. elinava@netvision.net.il

The Annals of Thoracic Surgery
|September 25, 2007
PubMed

Insights

Patients with pituitary adenoma undergoing cardiopulmonary bypass for coronary artery bypass grafting risk pituitary apoplexy. Off-pump surgery may prevent this serious complication, preserving neurological function.

Area of Science:

  • Cardiovascular Surgery
  • Neurosurgery
  • Endocrinology

Background:

  • Pituitary adenoma is a common pituitary tumor.
  • Coronary artery bypass grafting (CABG) is a surgical procedure to improve blood flow to the heart.
  • Cardiopulmonary bypass (CPB) is frequently used during CABG.

Purpose of the Study:

  • To investigate the incidence of pituitary apoplexy in patients with pituitary adenoma undergoing CABG.
  • To compare outcomes between CABG with and without CPB in patients with pituitary adenoma.
  • To recommend surgical strategies to mitigate risks.

Main Methods:

  • Retrospective case review of patients with pituitary adenoma undergoing CABG.
  • Comparison of neurological outcomes in patients who underwent CABG on-pump versus off-pump.
  • Analysis of complications, specifically pituitary apoplexy.

Main Results:

  • Three patients with pituitary adenoma who underwent CABG with CPB developed pituitary apoplexy with neurological deficits.
  • One patient with pituitary adenoma who underwent CABG off-pump remained neurologically intact.
  • Pituitary apoplexy can lead to severe neurological deficits and mortality.

Conclusions:

  • Cardiopulmonary bypass during CABG may precipitate pituitary apoplexy in patients with pituitary adenoma.
  • Off-pump CABG is a potentially safer alternative for patients with pituitary adenoma.
  • Surgeons should consider off-pump techniques to prevent CPB-induced pituitary apoplexy.

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