Coronary Artery Vasospasm After Mechanical Aortic Valve Replacement: A Case Report.

Autor:	Mussie E; Department of Radiology, Lewis Katz School of Medicine at Temple University, Temple University Hospital, Philadelphia, USA., DeWitte N; Department of General Surgery, Lewis Katz School of Medicine at Temple University, Temple University Hospital, Philadelphia, USA., Goulet M; Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Temple University Hospital, Philadelphia, USA., Garfield J; Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Temple University Hospital, Philadelphia, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2023 Nov 30; Vol. 15 (11), pp. e49747. Date of Electronic Publication: 2023 Nov 30 (Print Publication: 2023).
DOI:	10.7759/cureus.49747
Abstrakt:	Coronary artery vasospasm is a rare but fatal postoperative complication of cardiothoracic surgery. This phenomenon can occur directly after surgery or several hours postoperatively. Most reported cases have occurred after CABG surgery and less commonly after valve replacement. Patients can present with various symptoms, and physicians must be familiar with the indications to suspect coronary artery vasospasm to avoid adverse outcomes. We present a case of a 60-year-old female who suffered a cardiac arrest with refractory ventricular fibrillation due to coronary artery vasospasm following aortic valve replacement. During resuscitation, she underwent central veno-arterial extracorporeal membrane oxygenation (VA-ECMO) cannulation for hemodynamic support. She subsequently underwent urgent left heart catheterization, revealing vasospasm of the left anterior descending artery, early first diagonal, early first obtuse marginal, and non-dominant right coronary artery. Vasospasm was successfully treated with intracoronary nitroglycerin and nicardipine. This case report demonstrates the importance of early consideration of coronary artery vasospasm as a cause of postoperative arrest following cardiac surgery. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2023, Mussie et al.)
Databáze:	MEDLINE
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