Nordstrom L A, Lillehei J P, Adicoff A, Sako Y, Gobel F L
Am Heart J. 1975 Feb;89(2):236-41. doi: 10.1016/0002-8703(75)90053-8.
Two patients with Prinzmetal's variant angina had recurrent episodes of resting chest pain, ST segment elevation, QRS widening, ventricular tachycardia, and ventricular fibrillation. These eqisodes were unresponsive to medical therapy including lidocaine, procaine amide, and quinidine sulfate. Coronary arteriography revealed severe obstructive coronary artery disease, involving more than one coronary artery, in both patients. Aorticocoronary saphenous vein grafts were utilized to bypass significant disease in each patient. In one patient blood flow through the grafts was measured at 90 and 65 ml per minute, respectively, at operation and patent grafts were demonstrated six months postoperatively. Neither patient has had recurrence of chest pain or evidence of ventricular tachycardia at one year or 2 1/2 years postoperatively. Postoperative resting and maximal exercise ECG's are normal. Coronary artery surgery may be an effective method of therapy for ischemic ventricular tachycardia when medical therapy fails.
两名患有变异型心绞痛（Prinzmetal's variant angina）的患者出现了静息性胸痛、ST段抬高、QRS波增宽、室性心动过速和心室颤动的反复发作。这些发作对包括利多卡因、普鲁卡因酰胺和硫酸奎尼丁在内的药物治疗均无反应。冠状动脉造影显示，两名患者均患有严重的阻塞性冠状动脉疾病，累及不止一支冠状动脉。每名患者均采用了主动脉冠状动脉大隐静脉移植术来绕过严重病变。在一名患者中，术中测量移植血管的血流量分别为每分钟90毫升和65毫升，术后6个月显示移植血管通畅。两名患者在术后1年和2年半时均未出现胸痛复发或室性心动过速的迹象。术后静息和最大运动时的心电图均正常。当药物治疗无效时，冠状动脉手术可能是治疗缺血性室性心动过速的有效方法。
