Combined surgery for coronary artery disease and pheochromocytoma.
OBJECTIVE
To report a case of severe coronary artery disease complicating pheochromocytoma, managed with combined coronary artery bypass grafting (CABG) and adrenalectomy.


METHODS
A 55-yr-old woman presented with poorly controlled hypertension and investigation revealed an active pheochromocytoma of her left adrenal gland. During medical preparation for adrenalectomy, she developed an acute myocardial infarct complicated with unstable angina. This required urgent CABG, and combined surgery for the triple vessels coronary artery disease and the pheochromocytoma was planned. We explain the details of medical preparation before surgery and the anesthetic considerations during the surgical procedure. Postoperative recovery was normal and no complication occurred. Even if the pheochromocytoma was malignant, her urinary catecholamines two months after the surgery were normal and remain normal after more than two years of follow-up.


CONCLUSIONS
We report a patient who underwent combined CABG and adrenalectomy for pheochromocytoma. The CABG was done first, followed by the adrenalectomy with invasive monitoring. The procedure was well tolerated with cure of the two underlying conditions. So we propose that combined procedure should be considered in this clinical setting.
Baillargeon
J P
JP
Department of Medicine, Université de Sherbrooke, Centre Universitaire de Santé de l'Estrie, Québec, Canada.
Pek
B
B
Teijeira
J
J
Poisson
J
J
van Rossum
N
N
Langlois
M F
MF
D000310:Adrenal Gland Neoplasms / Q000150:complications / Q000601:surgery*; D000315:Adrenalectomy; D000789:Angina, Unstable / Q000150:complications / Q000601:surgery; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000601:surgery*; D010673:Pheochromocytoma / Q000150:complications / Q000601:surgery*