Pituitary apoplexy and CABG: should we change our strategy?
Patients with pituitary adenoma that had coronary artery bypass grafting with cardiopulmonary bypass had pituitary apoplexy develop with neurologic deficits and even death. Four patients with pituitary adenoma underwent coronary artery bypass grafting operations (3 patients had coronary artery bypass grafting on bypass, 1 of them with known pituitary adenoma. All of them had pituitary apoplexy develop with neurologic deficits). One patient with known pituitary adenoma who had a coronary artery bypass grafting operation off pump was neurologically intact. Our recommendation is to consider operating on patients with pituitary adenoma who need coronary artery bypass grafting operation off pump, and to prevent pituitary apoplexy that cardiopulmonary bypass may cause.
Levy
Eli
E
Division of Cardiothoracic Surgery, Hadassah University Hospital, Jerusalem, Israel. elinava@netvision.net.il
Korach
Amit
A
Merin
Gideon
G
Feinsod
Moshe
M
Glenville
Brian
B
D000368:Aged; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010899:Pituitary Apoplexy / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D010911:Pituitary Neoplasms / Q000150:complications*; D011183:Postoperative Complications / Q000517:prevention & control; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome