title: [Severe cardiovascular complications due to the pituitary adenoma with acromegaly. An interdisciplinary approach to the treatment. A case report].
abstract: 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.
authors.affiliation: Klinika Neurochirurgii, Wojskowy Instytut Medyczny, ul. Szaserów 128, 00-909 Warszawa. gmz@wim.mil.pl
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Zieliński
authors.forename: Piotr
authors.initials: P
authors.lastname: Hendzel
authors.forename: Przemysław
authors.initials: P
authors.lastname: Szałański
authors.forename: Jarosław
authors.initials: J
authors.lastname: Gołowicz
authors.forename: Leszek
authors.initials: L
authors.lastname: Gryszko
authors.forename: Jan Krzysztof
authors.initials: JK
authors.lastname: Podgórski
mesh_terms: 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