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[Open heart surgery in patient with hyperthyroidism]

O Satoh¹, M Miyabe, M Kawamata

¹Department of Anesthesia, Kushiro City General Hospital.

Masui. the Japanese Journal of Anesthesiology

|March 1, 1994

Summary

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Maintaining euthyroid status long-term before surgery is crucial for patients with atrial septal defect (ASD) and hyperthyroidism. This case study highlights successful ASD repair without thyroid complications by managing thyroid function preoperatively.

Area of Science:

Cardiology
Endocrinology
Surgical Management

Background:

A 57-year-old male with a history of hyperthyroidism due to a giant thyroid adenoma required atrial septal defect (ASD) closure.
The patient had been euthyroid for seven years on oral thiamazole, with normal thyroid function maintained for four years prior to surgery.

Observation:

During ASD patch closure, the patient exhibited hypothyroidism despite preoperative thiamazole administration.
The cardiac surgery proceeded without immediate thyroid-related complications.

Findings:

Thyroid function testing revealed hypothyroidism intraoperatively, despite a history of controlled hyperthyroidism.
Postoperative management included intramuscular and subsequent oral thiamazole, preventing thyroid storm.

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Implications:

Long-term preoperative control of thyroid function is vital for patients with coexisting heart disease and hyperthyroidism undergoing surgery.
Careful perioperative thyroid management can prevent complications such as thyroid storm in high-risk surgical patients.