Surgical treatment of amiodarone-induced thyrotoxicosis in an adult with congenital heart disease: An anesthetists perspective

Abstract

Objective: Unusual setting of medical care Background: Amiodarone-induced thyrotoxicosis can be refractory to medical treatment seldom requiring surgical interven-tion. Herewith, we present the first case to date of amiodarone-induced thyrotoxicosis in a congenital heart disease post-Senning procedure requiring emergent surgical management. Case Report: A 19-year-old-male patient with a history of a complex congenital heart disease developed severe pulmonary baffle stenosis and atrial fibrillation that was medically treated with amiodarone, upon which he developed. Amiodarone-induced thyrotoxicosis that was refractory to medical treatment. The patient was taken to the operating room for surgical treatment of his refractory disease. An intraoperative transesophageal echocar-diography was employed ensuring adequate monitoring of his systemic vascular resistance and pulmonary arterial pressures. Conclusions: Because of the high risk of cardiac complications induced by thyroid-induced thyrotoxicosis, patients with complex congenital heart disease require careful intraoperative monitoring in anticipation of tragic events. This is a report of a single case of successful operation on a patient in the thyrotoxic state.