A Combined Open-Heart Coronary Artery Bypass Surgery and Subtotal Thyroidectomy in a 54-year-old patient Case Report

Abstract

BACKGROUND: Combined open-heart surgery and thyroidectomy is a rare procedure. However, somedifficulties will occur for cardiac surgery when thyromegaly extends into the retrosternal space.CASE DETAILS: A 54-year-old woman suffering from dyspnea, chest pain and decreased leftventricular function (EF=40%) was diagnosed with coronary artery disease (3 vessel disease) andbecame candidate for coronary artery bypass grafting (CABG). Also, she had multinodular goiter withnormal thyroid function test. After midsternotomy, a huge goiter was seen in the upper mediastinum.Because the mass had covered the ascending aorta and involved the posterior aspect of the innominatevein making access to aorta impossible, thyroidectomy was performed at first followed by CABG. Post-operation course was satisfactory. Fourteen months later, the patient was euthyroid and in NYHA class1.CONCLUSION: The evidence of the case showed that combined CABG and thyroidectomy can beperformed safely.