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[Cardiac surgery for the patients with hyperthyroidism]

M Onoe1, T Magara, Y Yamamoto

  • 1Department of Cardiac Surgery, Shiga Medical Center for Adults, Shiga, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|May 22, 1998
PubMed
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Open heart surgery in hyperthyroid patients is feasible with careful management. Proactive thyroid function control effectively prevents thyrotoxic crisis during the perioperative period, ensuring good surgical outcomes.

Area of Science:

  • Cardiology
  • Endocrinology
  • Surgical Management

Background:

  • Hyperthyroidism poses a risk of thyrotoxic crisis during perioperative periods for patients undergoing open heart surgery.
  • Close monitoring and meticulous control of thyroid function are crucial for these patients.

Observation:

  • Two patients with hyperthyroidism underwent open heart surgery: one for mitral valve repair and another for aortic valve replacement.
  • Both patients required prolonged cardiopulmonary bypass during their respective procedures.

Findings:

  • Thyrotoxic crisis was successfully prevented in both patients.
  • Prevention was achieved through a multi-faceted approach: preoperative anti-thyroid agents, immediate preoperative Lugol's iodine solution, and early postoperative re-administration of anti-thyroid agents.

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Implications:

  • This case series demonstrates the safety and efficacy of managing hyperthyroid patients undergoing complex cardiac surgery.
  • The described perioperative management strategy provides a valuable model for preventing thyrotoxic crisis in similar high-risk patient populations.
  • Effective thyroid function control is key to successful open heart surgery outcomes in patients with hyperthyroidism.