Changes in the vulnerability of clinical manifestations of thyrotoxic cardiomyopathy as indicators of remote results of surgical treatment in patients with toxic goiter

Abstract

The aim of the work – improvement of the evaluation method of remote results of surgical treatment in patients with toxic goiter, taking into account the changes in the severity of clinical manifestations of thyrotoxic cardiomyopathy Materials and methods. The research was conducted in 150 patients operated for toxic goiter of moderate severity (48) and severe (102). The method of estimation of remote results of surgical treatment, taking into account the regression of signs of thyrotoxic cardiomyopathy and gradation and division into good, satisfactory, unsatisfactory and ineffective treatment, was developed. Results and discussion. A good remote outcome of surgical treatment of thyrotoxicosis was achieved in 26 (54.2 %) patients with moderate thyrotoxicosis and in 9 (8.8%) patients with severe thyrotoxicosis, satisfactory in 21 (43.7 %) and 36 (35, 3%) cases respectively and unsatisfactory – in 1 (2.0 %) and 33 (32.4 %). Ineffective surgical treatment was recognized in 24 (23.5 %) patients. Unsuccessful results and ineffective surgical treatment of toxic goiter were found in patients with severe heart rate rhythm disorders, structural and functional changes in the cardiac muscle and functional classes II and III. Conclusions. Long-term results of surgical treatment of patients with toxic goiter are determined by the severity of thyrotoxic cardiomyopathy. In cases of severe thyrotoxicosis, the question of the need for surgical treatment should be put in the development of severe heart rhythm disorders and structural and functional changes in the heart muscle.

Keywords

• thyrotoxicosis
• surgical treatment
• long-term results