Combined cardiac surgery and total thyroidectomy - A case report

A 65-year-old woman with aortic stenosis, ischemic heart disease, and Grave s' disease had complained of effort angina. She then suffered from liver dy sfunction due to treatment with antithyroid drugs. One year after the start of radioiodine administration, she demonstrated unstable angina with palpi tation and sweating. Laboratory studies revealed a recurrent hyperthyroid s tate, and a second coronary angiogram revealed progressive ischemic heart d isease. Combined coronary artery bypass grafting, aortic valve replacement, and total thyroidectomy were performed. The postoperative course was uneve ntful without any problems associated with hyperthyroidism or hypothyroidis m. Combined cardiac surgery and total thyroidectomy can be performed safely if the perioperative levels of thyroid hormone are maintained at euthyroid or hypothyroid levels.