Carneiro Neto Joaquim David, Lima Neto José Antonio de, Simões Rosa Maria da Costa, Stolf Noedir Antonio Groppo
Hospital Beneficência Portuguesa, São Paulo, Brazil. davidc.neto @ gmail.com
Rev Bras Cir Cardiovasc. 2010 Jul-Sep;25(3):410-4. doi: 10.1590/s0102-76382010000300020.
Coronary artery spasm in perioperative of coronary artery bypass graft surgery is a serious complication, with high rate mortality. Patient 51 years-old submitted to coronary artery bypass graft surgery without Extracorporeal Circulation. The patient evolved in 1st post operative (PO) day with enzymatic alteration and ST-elevation, developing soon afterwards in ventricular fibrillation, defibrillation with success. Cardiac catheterization showed important spasm of all coronary arteries and anastomosis between the left internal thoracic artery and the left anterior interventricular artery. Intracoronary Vasodilators and intra-graft, with re-establishment of their usual and immediate calibers to improve clinic and Hemodynamic stability was used. Satisfactory evolution, discharged at 13rd PO day.
冠状动脉搭桥手术围手术期的冠状动脉痉挛是一种严重并发症,死亡率很高。一名51岁患者接受了非体外循环冠状动脉搭桥手术。患者在术后第1天出现酶学改变和ST段抬高,随后很快发展为心室颤动,成功除颤。心脏导管检查显示所有冠状动脉及左胸廓内动脉与左前降支动脉之间的吻合处有严重痉挛。使用了冠状动脉内血管扩张剂和移植物内药物,使其管径恢复正常并即刻改善临床症状和血流动力学稳定性。病情进展顺利,患者于术后第13天出院。