Combined Thyroid and Cardiovascular Surgery in an Endemic Goiter Area

Objective: Thyroid nodules are prevalent in southern Italy, with specific regions identified as endemic for goiter. This issue is frequently observed in patients requiring cardiovascular surgery. The study evaluates the feasibility and safety of combined interventions involving thyroid and cardiovascular surgeries. Methods: A retrospective study of 4843 cardiac operations conducted between 2010 and 2021 identified ten cases of thyroid surgery performed alongside cardiac or vascular procedures. These procedures encompassed coronary artery bypass grafting, valvular surgeries, and carotidectomy. The patients’ medical records were examined, focusing on demographic and surgical data, including age, sex, pre-operative diagnoses, cardiovascular condition, surgical approaches, post-operative stay, complications, and histological findings. Results: Seven males and three females underwent surgeries for coronary artery disease, valvular disorders, or both, along with carotidectomy and thyroid-related interventions. Anticoagulation with intravenous heparin was administered both perioperatively and postoperatively. No cases of neck bleeding occurred during these periods, but two out of ten patients developed wound infections. Histological examination revealed benign thyroid disease in eight patients, while two were diagnosed with papillary microcarcinoma. Conclusion: The study demonstrates that combined thyroid and cardiovascular surgeries are both feasible and safe. However, thyroid surgery should be reserved for cases involving intra-thoracic goiter or toxic goiter, as these conditions could exacerbate post-operative cardiac complications.