[Severe cardiovascular complications due to the pituitary adenoma with acromegaly. An interdisciplinary approach to the treatment. A case report].
Acromegaly reduces life expectancy and leads to 3-5-fold increase in mortality. The main causes are cardiovascular, pulmonary and enhanced prevalence of deaths from malignancy. Successful therapy ought to normalize GH, IGF-I secretion, remove the adenoma mass and its local pressure effects and preserve pituitary functions intact to improve systemic morbidity and normalize mortality. The primary therapy for most patients with acromegaly is still transsphenoidal adenomectomy. The authors present a 64-year-old woman with diagnosed GH-secreting pituitary macroadenoma suffering from severe coronary heart disease and diabetes mellitus. Somatostatin analogue therapy was ineffective in our patient. She was unfit for transsphenoidal adenomectomy. The patient was qualified for coronary artery bypass grafting after cardiological investigation. We have decided to carry out the bypass grafting and transsphenoidal adenomectomy during one anaesthesia. Both surgical procedures and postoperative time were uncomplicated. Our patient feels well and she is in outpatient follow-up.
Zieliński
Grzegorz
G
Klinika Neurochirurgii, Wojskowy Instytut Medyczny, ul. Szaserów 128, 00-909 Warszawa. gmz@wim.mil.pl
Hendzel
Piotr
P
Szałański
Przemysław
P
Gołowicz
Jarosław
J
Gryszko
Leszek
L
Podgórski
Jan Krzysztof
JK
D000172:Acromegaly / Q000209:etiology / Q000601:surgery*; D000236:Adenoma / Q000150:complications / Q000601:surgery*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000150:complications / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome