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Simultaneous coronary artery bypass grafting,replacement of the innominate artery and subtotal thyroidectomy in a 61 year-old patient:a case-report

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Chinese Medical Journal 2005年第8期118卷 699-701页

作者： Jens Litmathe Muhammed Kurt klaus grabitz Wolfram T.Knoefel Emmeran Gams Department of Thoracic and Cardiovascular Surgery Heinrich-Heine-University HospitalD-40225 DuesseldorfGermany Department of Thoracic and Cardiovascular SurgeryHeinrich-Heine-University HospitalD-40225 DuesseldorfGermany Department of Vascular Surgery and Kidney TransplantationHeinrich-Heine-University HospitalD-40225 DuesseldorfGermany Department of Visceral and General SurgeryHeinrich-Heine-University HospitalD-40225 DuesseldorfGermany Department of Thoracic and Cardiovascular SurgeryHeinrich-Heine-University HospitalD-40225 DuesseldorfGermany

The management of patients with coexisting diseases who undergo cardiac surgery is a subject to controversial discussions as the operative mortality is thought to be increased by simultaneous procedures. Traditionally, the surgical procedures have been staged with the cardiac surgery performed first followed by the visceral operation at a later date. However, especially in cases of malignant disease (e. g. pulmonary or abdominal) the curative treatment is delayed and the additional costs of two settings have to be considered. 1 Although encouraging results have been reported concerning simultaneous pulmonary tumor resection, carotid endarterectomy or abdominal aneurysm repair, 2-5 detailed knowledge concerning further coexisting non-cardiac diseases requiring surgical therapy is still lacking. In some extremely rare cases patients suffer from more than just one coexisting disease of different origins: the current report focuses on a 61-year-old female patient suffering from ischemic heart disease, occlusion of the innominate artery and a retrosternal goiter as an incidental finding. She was treated in a simultaneous procedure with three operations in only one setting. The perioperative features of this special case are reflected in the following course.

关键词： concomitant operation · ischemic heart disease · innominate artery · retrosternal goiter

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