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Diffuse Coronary Vasospasm After Mitral Valve Replacement, Maze Procedure, and Tricuspid Valve Repair
Andrew J Gorton1, Peter Rodgers-Fischl1, John Gurley2
1Department of Surgery, Division of Cardiothoracic Surgery, University of Kentucky, Lexington, USA.
Cureus
|March 29, 2023
Summary
Coronary vasospasm, a rare complication after heart surgery, can occur after mitral valve replacement. Intracoronary nitroglycerin effectively treated this vasospasm in a patient, showing its therapeutic potential.
Area of Science:
- Cardiology
- Cardiac Surgery
- Vascular Medicine
Background:
- Coronary vasospasm is a recognized complication following coronary artery bypass grafting (CABG).
- Its occurrence after non-coronary cardiac operations is infrequently documented.
- This case highlights a potential, albeit rare, complication in a different surgical context.
Observation:
- A 51-year-old male with nonischemic cardiomyopathy and atrial fibrillation underwent mitral valve replacement, tricuspid valve repair, and Maze procedure.
- Postoperatively, the patient developed diffuse coronary vasospasm, confirmed by emergent coronary angiography.
- Symptoms and angiographic findings improved following intracoronary nitroglycerin administration.
Findings:
- Diffuse coronary vasospasm can occur after mitral valve replacement surgery.
- Intracoronary nitroglycerin is an effective treatment for postoperative coronary vasospasm in this setting.
- This suggests vasodilating agents can successfully manage such complications.
Implications:
- Cardiac surgeons should consider coronary vasospasm in patients presenting with unexplained cardiac events post-mitral valve surgery.
- Early diagnosis and treatment with vasodilators like nitroglycerin can improve patient outcomes.
- This case expands the understanding of coronary vasospasm's potential triggers and management strategies in cardiac surgery.
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