Combined cardiothoracic surgery and interventions of the para/thyroid gland. A rare clinical cooperation.

OBJECTIVE: Simultaneous cardiothoracic and general surgical interventions are still a matter of controversy. We investigated the question whether combined open heart surgery or thoracic surgery and interventions of the parathyreoid respectively thyroid gland may be helpful for the patients. PATIENTS AND METHODS: The records of six patients (age range: 29-78 years) undergoing simultaneous cardiothoracic and para-/thyroid interventions were examined. Cardiothoracic surgery consisted in three patients of coronary artery bypass grafting, in one of aortic valve replacement, in one of thymus resection and finally in one of resection of a mediastinal Hodgkin's lymphoma. In combination with these procedures three patients underwent a subtotal goiter resection, two patients had a resection of a parathyroid adenoma and one patient underwent a right-sided hemithyroidectomy.
RESULTS: One patient died in the early postoperative course due to global myocardial failure on the base of preoperatively existing reduced left ventricular function. The other postoperative courses were uneventful. The duration of operation was between 165 and 687 min, perfusion time in case of open heart surgery was between 92 and 311 min, ischemic time ranged from 45 to 62 min. The length of hospital-stay ranged from 9 to 26 days. The postoperative follow-up showed all five patients to be in a satisfactory cardiovascular condition. There were no signs of recurrence of either para-/thyroid or Hodgkin's disease.
CONCLUSIONS: The postoperative course does not indicate an increased number of complications, although the total duration of operation and anesthesia is prolonged. Thus we conclude that simultaneous cardiothoracic and endocrine surgery of the para-/thyroid gland can be performed with acceptable risk in cases of preoperative low-risk assessment.