Biomaterial Database

[Severe coronary artery spasm immediately after aortic valve replacement]. 2010

Sadanari Sawaki, and Akio Matsuura, and Hideki Ito, and Shunei Saito, and Haruki Takemura, and Ken Miyahara, and Shinichi Ashida, and Shunsuke Mori, and Akira Takanohashi, and Kei Yagami, and Masato Usui, and Yuuichi Hirate

Department of Cardiovascular Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan.

We report a case of 72-year-old man with severe manifestations of coronary artery spasm immediately after aortic valve replacement (AVR), which was associated with hemodynamic and arrhythmic instability. The AVR was performed under mild hypothermic cardiopulmonary bypass (34 degrees C), and retrograde blood cardioplegia was intermittently delivered at the same temperature. Immediately after the operation, the patient suddenly developed severe bradycardia and hypotension, and repeated ventricular fibrillation. Percutaneous cardiopulmonary support system (PCPS) and intra-aortic balloon pumping (IABP) were required for this circulatory collapse. Echocardiography revealed left ventricular segmental dysfunction, and coronary artery bypass grafting (CABG) to the right coronary artery and the left ascending artery was performed [during CABG, coronary spasm was strongly suspected by repetitive ST elevation and depression on electrocardiogram (ECG) monitor]. Eventually, the spasm subsided with the intravenous infusion of nitrates, nicorandil, and diltiazem. The remaining postoperative course was uneventful and the patient was discharged on the 24th postoperative day in good clinical condition.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D003329	Coronary Vasospasm	Spasm of the large- or medium-sized coronary arteries.	Coronary Artery Spasm,Coronary Artery Vasospasm,Artery Spasm, Coronary,Artery Vasospasm, Coronary,Coronary Artery Spasms,Coronary Artery Vasospasms,Coronary Vasospasms,Spasm, Coronary Artery,Vasospasm, Coronary,Vasospasm, Coronary Artery
D006350	Heart Valve Prosthesis	A device that substitutes for a heart valve. It may be composed of biological material (BIOPROSTHESIS) and/or synthetic material.	Prosthesis, Heart Valve,Cardiac Valve Prosthesis,Cardiac Valve Prostheses,Heart Valve Prostheses,Prostheses, Cardiac Valve,Prostheses, Heart Valve,Prosthesis, Cardiac Valve,Valve Prostheses, Cardiac,Valve Prostheses, Heart,Valve Prosthesis, Cardiac,Valve Prosthesis, Heart
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly
D001021	Aortic Valve	The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle.	Aortic Valves,Valve, Aortic,Valves, Aortic