Hipopituitarizm’li bir olguda koroner arter baypas cerrahisi: Vaka sunumu

Koroner arter baypas cerrahisi yapılan hastalarda preoperatif hipopituitarizmvarlığı hem anestezi hem de cerrahi isleme bağlı komplikasyonların görülme riskiniarttırmaktadır. Özellikle adrenokortikal ve tiroid hormanlarının uygun dozlarda perioperatif replasmanı bu hasta grubunda yasamsal önem arz etmektedir. Bu yazıdahipopituitarizm nedeniyle takip edilen bir hastada basarılı bir sekilde gerçeklestirilenkoroner arter baypas cerrahisi anlatılmıs ve bu hasta grubunda uygulanması gerekenoptimal peroperatif tedavi stratejisi tartısılmıstır.

Coronary artery bypass grafting in a patient with hypopituitarism: Report of a case

Presence of hypopituitarism in patients undergoing coronary artery bypass grafting increases the risks related to both anesthesia and surgery. Perioperative replacement of adrenocortical and thyroid hormones in appropriate amounts plays a vital role in the management of such patients. In this paper successful coronary artery bypass grafting in a patient with hypopituitarism is presented and the perioperative management strategy in these patients is discussed.

PDF

___

1. Bayraktaroglu T, Azezli A. Hypopituitarism and replacement therapy: medical education. Turkiye Klinikleri J Med Sci 2007; 27: 247-260.
2. Yasuda T, Kawasuji M, Ishida Y, Sakakibara N, Fujii S, Nishida S, Watanabe Y. Coronary artery bypass grafting in patients with hypopituitarism. Jpn Circ J 2000; 64: 207–8.
3. Syed AU, Al Fagih MR, Fouda M. Coronary bypass surgery in patients with Sheehan’s syndrome. Eur J Cardiothorac Surg 2001; 20: 1264-6.
4. Diederich S, Franzen NF, Bähr V, Oelkers W. Severe hyponatremia due to hypopituitarism with adrenal insuffciency: report on 28 cases. Eur J Endocrinol 2003; 148: 609-17.
5. Hubay CA, Weckesser EC, Levy RP. Occult adrenal insuffciency in surgical patients. Ann Surg 1975; 181: 325-32.
6. Ladenson PW, Levin AA, Ridgway EC, Daniels GH. Complications of surgery in hypothyroid patients. Am J Med 1984; 77: 261-6.
7. Khalpey ZI, Ganim RB, Rawn JD. Postoperative Care of Cardiac Surgery Patients. Card Surg Adult 2008; 3: 465-486.
8. Pham PC, Pham PA, Pham PT. Sodium and Water Disturbances in Patients With Sheehan’s Syndrome. Am J Kidney Dis 2001; 38: E14.
9. Mattke AF, Vender JR, Anstadt MP. Pituitary Apoplexy Presenting as Addisonian Crisis after Coronary Artery Bypass Grafting. Tex Heart Inst J 2002; 29: 193-9.