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Postoperative diffuse coronary spasm after two valve surgery - a rare phenomenon.
Tanveer Ahmad1, Kolkebaile Sadanand Kishore2, Nandakumar Neralakere Maheshwarappa3
1Department of Cardiothoracic Surgery, Sagar Hospital-DSI, Banshankari, Bangalore 560078, India.
Indian Heart Journal
|October 4, 2015
Summary
Postoperative coronary artery spasm, a serious cardiac surgery complication, can occur after valve replacement, not just bypass surgery. Coronary angiography effectively diagnosed and treated this condition with nitroglycerin.
Area of Science:
- Cardiology
- Cardiac Surgery
- Vascular Medicine
Background:
- Postoperative coronary artery spasm is a known complication of cardiac surgery, particularly coronary artery bypass grafting.
- It typically presents with electrocardiographic changes and chest pain.
Observation:
- A 63-year-old male developed diffuse coronary artery spasm affecting the entire coronary tree post-aortic and mitral valve replacement.
- The patient exhibited significant electrocardiographic changes indicative of myocardial ischemia.
Findings:
- Coronary angiography confirmed diffuse spasm of the entire coronary tree.
- Intracoronary nitroglycerin administration resulted in complete resolution of the spasm.
Implications:
- This case underscores that postoperative coronary artery spasm can occur following valve replacement surgery, broadening its known association beyond coronary bypass procedures.
- Coronary angiography serves as a valuable diagnostic and therapeutic tool for managing postoperative coronary artery spasm.
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