Combined surgery for coronary artery disease and pheochromocytoma

Purpose: To report a case of severe coronary artery disease complicating ph eochromocytoma, managed with combined coronary artery bypass grafting (CABG ) and adrenalectomy. Clinical features: A 55-yr-old woman presented with poorly controlled hyper tension and investigation revealed an active pheochromocytoma of her left a drenal gland. During medical preparation for adrenalectomy, she developed a n acute myocardial infarct complicated with unstable angina. This required urgent CABG, and combined surgery for the triple vessels coronary artery di sease and the pheochromocytoma was planned. We explain the details of medic al preparation before surgery and the anesthetic considerations during the surgical procedure. Postoperative recovery was normal and no complication o ccurred. Even if the pheochromocytoma was malignant, her urinary catecholam ines two months after the surgery were normal and remain normal after more than two years of follow-up. Conclusion: We report a patient who underwent combined CABG and adrenalecto my for pheochromocytoma. The CABG was done first, followed by the adrenalec tomy with invasive monitoring. The procedure was well tolerated with cure o f the two underlying conditions. So we propose that combined procedure shou ld be considered in this clinical setting.