Gorton Andrew J, Rodgers-Fischl Peter, Gurley John, Dorfling Johannes, Keshavamurthy Suresh
Department of Surgery, Division of Cardiothoracic Surgery, University of Kentucky, Lexington, USA.
Department of Cardiovascular Medicine, University of Kentucky, Lexington, USA.
Cureus. 2023 Feb 24;15(2):e35405. doi: 10.7759/cureus.35405. eCollection 2023 Feb.
Coronary vasospasm is a known complication after coronary artery bypass grafting surgery but has rarely been described in non-coronary cardiac operations. We report the case of a 51-year-old male with nonischemic cardiomyopathy and paroxysmal atrial fibrillation. He presented with severe mitral and tricuspid regurgitation and was taken for mitral valve replacement, tricuspid valve repair, and Maze procedure. Postoperative emergent coronary angiography demonstrated diffuse coronary vasospasm. Injection of intracoronary nitroglycerin led to clinical and angiographic improvement. This demonstrates the possibility of coronary vasospasm following mitral valve replacement and effective treatment with intracoronary administration of vasodilating agents.
冠状动脉痉挛是冠状动脉旁路移植手术后已知的并发症，但在非冠状动脉心脏手术中很少被描述。我们报告一例51岁男性，患有非缺血性心肌病和阵发性心房颤动。他因严重二尖瓣和三尖瓣反流就诊，接受了二尖瓣置换术、三尖瓣修复术和迷宫手术。术后急诊冠状动脉造影显示弥漫性冠状动脉痉挛。冠状动脉内注射硝酸甘油后临床和血管造影表现均有改善。这表明二尖瓣置换术后发生冠状动脉痉挛的可能性以及冠状动脉内给予血管扩张剂的有效治疗作用。
