Takeda Yoshihiro, Yasuga Yuji, Kitazume Rika, Hayashi Noriyuki, Nakagawa Yasuhiko, Nojima Yuhei, Sumitsuji Satoru, Masai Takafumi, Nagai Yoshiyuki, Sasako Yoshikado, Nakano Susumu
Division of Cardiology, Heart Institute, Rinku General Medical Center, Izumisano, Osaka.
J Cardiol. 2005 Feb;45(2):61-8.
Perioperative coronary vasospasm has been recognized as a possible cause of myocardial infarction or low output syndrome after open heart operations. A 57-year-old male suffered cardiogenic shock immediately after off-pump coronary artery bypass grafting surgery. Emergent angiography performed under intraaortic balloon pumping and percutaneous cardiopulmonary support revealed severe multivessel coronary vasospasm which was effectively treated with a high dose intracoronary administration of isosorbide dinitrate. Emergent angiography for patients with cardiogenic shock after open heart operation is feasible and effective for the diagnosis and treatment of perioperative coronary vasospasm.
围手术期冠状动脉痉挛已被认为是心脏直视手术后心肌梗死或低心排血量综合征的可能原因。一名57岁男性在非体外循环冠状动脉搭桥手术后立即发生心源性休克。在主动脉内球囊反搏和经皮心肺支持下进行的急诊血管造影显示严重的多支冠状动脉痉挛，经冠状动脉内高剂量给予硝酸异山梨酯有效治疗。心脏直视手术后心源性休克患者的急诊血管造影对于围手术期冠状动脉痉挛的诊断和治疗是可行且有效的。
