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coronary artery bypass graft pheochromocytoma

James Roy, Zakir Akhunji, Virag Kushwaha, James Mackie, Nigel Jepson
Pheochromocytomas have been reported prior to and during coronary artery bypass surgery. We present a patient with an undiagnosed pheochromocytoma who presented with labile hypertension following coronary artery bypass surgery. This case calls attention to the inclusion of an undiagnosed pheochromocytoma in the differential diagnosis for all patients who develop labile hypertension in the postoperative period following cardiac surgery.
October 3, 2016: Journal of Cardiac Surgery
Kristen Seery, Burak Ilsin, Alexander Kulik
The hemodynamic management of a patient with a pheochromocytoma presents special challenges due to the episodic release of catecholamines from the tumor, which threatens to provoke a hypertensive crisis. We present a patient with metastatic pheochromocytoma (bone, lung, lymph nodes) who underwent successful coronary artery bypass graft (CABG) surgery following premedication with phenoxybenzamine and metyrosine as well as the use of intraoperative phentolamine for the management of a hypertensive crisis in the operating room...
May 2015: Journal of Cardiac Surgery
T Zelinka, O Petrák, H Turková, R Holaj, B Strauch, M Kršek, A B Vránková, Z Musil, J Dušková, J Kubinyi, D Michalský, K Novák, J Widimský
Excess of catecholamines in pheochromocytoma is usually accompanied with classical symptoms and signs. In some cases, severe cardiovascular complications (e. g., heart failure, myocardial infarction) may occur. We performed a retrospective analysis focused on the incidence of cardiovascular complications (classified as follows: arrhythmias, myocardial involvement or ischemia and atherosclerosis, cerebrovascular impairment) before the establishment of diagnosis of pheochromocytoma among 145 subjects treated in our hospital...
May 2012: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
Jia-Lin Soon, Fiona A M Gibson, Shirley Janas, Ravi Pillai
We describe a 60-year-old man who underwent elective aortic valve replacement and concurrent single graft coronary artery bypass surgery with acute intraoperative hypertension. The early suspicion of a pheochromocytoma and immediate aggressive pharmacologic intervention are discussed. Expeditious surgery contributed to the good outcome. It is possible that the short implant time of the sutureless valve may have been beneficial, but this is speculative. The management of an undiagnosed pheochromocytoma presenting during general anesthesia is reviewed...
July 2010: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Asaka Watanabe, Yusuke Sugasawa, Maho Kakemizu, Kazuyoshi Aoyama, Toshimasa Akazawa, Eiichi Inada
We experienced pheochromocytoma resection and coronary artery bypass grafting under cardiopulmonary bypass (CPB). The patient was a 69-year-old man who was first diagnosed with atherosclerotic angina. During operation, his blood pressure increased at induction and manipulation of the tumor under CPB, associated with an increased serum noradrenaline concentration. Starting operation, we monitored using transesophageal echocardiography (TEE), and used that view for diagnosis and anesthetic or hemodynamic management...
September 2011: Masui. the Japanese Journal of Anesthesiology
Jian Zhou, Hai-Tao Chen, Jie Xiang, Xiao-Hong Qu, Yao-Quan Zhou, Wang-Fu Zang
Primary cardiac pheochromocytoma is an extremely rare neoplasm. We report a 15-year-old girl who was presented with paroxysmal hypertension. An iodine-131 metaiodobenzylguanidine scintigraphy scanning showed a pheochromocytoma in her right atrial and ventricular wall. The tumor was subsequently confirmed by magnetic resonance imaging and coronary angiogram. This patient underwent a successful surgical resection of the tumor, a reconstruction of the atrial ventricular wall and right coronary artery bypass grafting...
July 2009: Annals of Thoracic Surgery
Roland N Kaddoum, Joe Yu, Hong Wang, Elie J Chidiac
Concomitant coronary artery disease (CAD) and pheochromocytoma are rare. Patients with advanced CAD requiring coronary artery bypass graft (CABG) surgery and clinically active pheochromocytoma present a challenge to anesthesiologists. The risk is much higher if the patient is an anemic Jehovah's Witness because these patients refuse to receive blood or blood products, even when faced with a life-threatening hemorrhage. To our knowledge, this is the first case to describe the anesthetic management of an anemic Jehovah's Witness patient with pheochromocytoma presenting for off-pump CABG surgery...
June 2008: Middle East Journal of Anesthesiology
Yuko Kojima, Hiroto Kitahara, Hikaru Kimura, Toshitsugu Nakamura, Hiroaki Ina, Shigeru Yokota
We experienced simultaneous coronary artery bypass grafting and cardiac pheochromocytoma resection under cardiopulmonary bypass in a 79-year-old woman with atherosclerotic angina. During manipulation of the tumor under cardiopulmonary bypass, the serum norepinephrine concentration increased to over seventy times the normal limit, and there was a 25-mmHg rise in mean arterial pressure. Cardiopulmonary bypass has been recommended for the resection of cardiac pheochromocytoma to isolate the heart from the systemic circulation, and thus prevent massive catecholamine release when handling the tumor...
2007: Journal of Anesthesia
A C Y To, C Frost, A B Grey, M S Croxson, J Cooper
We report two patients who had successful combined coronary artery bypass grafting and excision of phaeochromocytoma. These cases represent the first reports of combined coronary artery bypass grafting and laparoscopic adrenalectomy for phaeochromocytoma and of combined coronary artery bypass grafting and excision of extra-adrenal phaeochromocytoma. With careful peri- and intra-operative management, especially in regard to haemostasis, combined operations for coronary artery disease and phaeochromocytoma are both feasible and safe...
July 2007: Anaesthesia
Eita Okuno, Manabu Kakinohana, Yuji Miyata, Kazuhiro Sugahara
We successfully treated a 61-year-old woman with a pheochromocytoma and angina. We administered doxizosin mesilate for a month to achieve a good control of blood pressure and CABG was followed without any problems. After 3 months, pheochromocytoma was resected. There were no cardiac ischemia during both operations. We believe that it is very important to control blood pressure and to determine which operation, CABG or the pheochromocytoma resection, should be performed first, in these cases.
February 2007: Masui. the Japanese Journal of Anesthesiology
S Shimosato, J G Carter, D H Brom, L F Hiratzka
No abstract text is available yet for this article.
August 1987: Journal of Cardiothoracic Anesthesia
Anuj Garg, Peter F Banitt
Pheochromocytomas are rare chromaffin cell tumors, 90% of which arise from the adrenal glands. Pheochromocytomas presenting with true myocardial infarction are even more rare. We report a 76-year-old man who had a previously undiagnosed pheochromocytoma, and presented with the uncommon complication of myocardial infarction. Our high-risk patient was managed with the combination of simultaneous coronary artery bypass grafting and adrenalectomy.
October 2004: Southern Medical Journal
A A Syed, H A Wheatley, M N Badminton, I F W McDowell
BACKGROUND: Induction of anaesthesia can precipitate catecholamine release from an undiscovered pheochromocytoma and induce a hypertensive crisis. However, it is assumed that catecholamine and metabolite values resulting from the effects of surgery per se in the early postoperative period would overlap with the values generated by a tumour, and it is not known how soon after biochemical investigations can be carried out. AIM: To study patterns of urinary catecholamine excretion and the feasibility of biochemical screening for phaeochromocytomas in the immediate postoperative period in otherwise healthy subjects undergoing a single type of major surgical procedure...
May 2004: Journal of Clinical Pathology
U Sartipy, G Lindvall, J Van Der Linden, G Dellgren
We report a successful off pump coronary artery bypass case in a patient with a pre-operatively undiagnosed pheochromocytoma. The patient had no signs of ischemia intra- or post-operatively due to aggressive antihypertensive treatment. We would also like to emphasize the importance of using an adequate stabilizing device in order to safely perform anastomoses in a situation like this.
September 2003: Acta Anaesthesiologica Scandinavica
Valérie Balabaud-Pichon, Pierre Bopp, François Levy, Jean Claude Thiranos, Annick Steib
No abstract text is available yet for this article.
June 2002: Journal of Cardiothoracic and Vascular Anesthesia
P Kumar, N Walcot, R Carpenter, R Uppal
Surgical management of patients with coexisting ischemic heart disease and pheochromocytoma remains challenging. We present one such case in which hybrid myocardial revascularization (angioplasty with stenting and off-pump coronary artery bypass grafting) and resection of pheochromocytoma were undertaken. Unusual features included simultaneous coronary artery surgery and tumor resection and, in particular, coronary artery surgery being performed without cardiopulmonary bypass.
December 2001: Annals of Thoracic Surgery
A M Sawka, W F Young, H V Schaff
Cardiac phaeochromocytoma is a rare cause of endocrine hypertension. We report a case of a 25-year-old woman, who presented with severe hypertension and intermittent chest pain. The patient denied typical phaeochromocytoma spells of palpitation, headache, and diaphoresis. The 24-hr urinary excretion of norepinephrine was increased sevenfold above the upper limit of normal; however, the excretion of total metanephrines, epinephrine, and dopamine were normal. Computed tomography (CT) scan of the abdomen was normal...
May 2001: Clinical Endocrinology
A Roy, A Sinha, M Scholar, K Macleod, B Glenville
No abstract text is available yet for this article.
October 2000: Journal of Thoracic and Cardiovascular Surgery
J P Baillargeon, B Pek, J Teijeira, J Poisson, N van Rossum, M F Langlois
PURPOSE: To report a case of severe coronary artery disease complicating pheochromocytoma, managed with combined coronary artery bypass grafting (CABG) and adrenalectomy. CLINICAL FEATURES: 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...
July 2000: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
S Inoue, Y Hayashi, Y Ohnishi, K Kikumoto, N Minamino, K Kangawa, H Matsuo, H Furuya, M Kuro
UNLABELLED: Adrenomedullin is a potent vasodilatory peptide originally identified in human pheochromocytoma. Plasma adrenomedullin increases during and after cardiopulmonary bypass (CPB). However, the site at which production of adrenomedullin is augmented has not been identified. In the present study, we examined the contribution of the cerebral vasculature to the production of adrenomedullin in patients before, during, and after CPB. Ten patients undergoing coronary artery bypass grafting with mild hypothermic CPB were studied...
May 1999: Anesthesia and Analgesia
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