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Ann Thorac Surg 1994;58:434-436
© 1994 The Society of Thoracic Surgeons

Articles

Should thyroid function be assessed before cardiopulmonary bypass operations?

T.Hugh Jones, MD*, Steven M. Hunter, MD, Alun Price, MSc, Gianni D. Angelini, MD

Departments of Medicine and Cardiothoracic Surgery and Clinical Chemistry, Northern General Hospital, Sheffield, United Kingdom

Accepted for publication December 9, 1993.

* Address reprint requests to Dr Jones, Department of Medicine, Clinical Sciences Centre, Northern General Hospital, Herries Rd, Sheffield, S5 7AU, England.

Thyroid function is depressed during and after cardiopulmonary bypass surgical procedures, and this may adversely affect myocardial performance. There is known to be a high prevalence of thyroid abnormalities in the elderly population, and many patients undergoing cardiac operations fall into this category. We have assessed thyroid function in 116 patients admitted for elective open heart procedures to determine the value of preoperative testing. Abnormalities in thyroid function were present in 13 (11.2%) of the patients studied, 3 of whom were receiving thyroxine therapy. One patient who had overt hypo thyroidism died postoperatively of a large cerebral infarct; 11 had elevated thyrotropin levels with normal serum thyroxine levels; and 1 who had overtreated hypothyroidism suffered fast atrial fibrillation postoperatively. No other complications were observed. These findings indicate that thyroid function should be assessed preoperatively in patients already on thyroxine therapy. Whether thyroid function should be evaluated routinely in all patients before operations involving cardiopulmonary bypass is not clear. Although there is a high incidence of abnormal laboratory results, there were no apparent adverse effects on the surgical outcome.




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