[Right coronary spasm immediately after coronary artery bypass grafting for the left coronary artery].
Right coronary spasm immediately after coronary artery bypass grafting for the left coronary artery in a 39-year-old male is described. After the patient was returned to ICU, ECG at leads II, III, and aVF changed suddenly, ventricular tachycardia (right ventricle origin) and cardiac arrest ensured. As neither administration of drug nor application of D.C. was effective. The chest was reopened at ICU. Though there was sufficient flow in the left coronary artery bypass graft flow, the right ventricle did not constrict at all. Right coronary artery spasm was diagnosed, and, upon application of the direct cardiac massage and D.C. at the cardiac surface, cardiac rhythm and blood pressure were normalized. IABP was inserted to improve cardiac function, and the chest was closed. In addition, nitroglycerin and diltiazem were infused continuously. No spasm has occurred after this episode, and the patient has been discharged and is doing well.
Ohtake
H
H
Department of Thoracic and Cardiovascular Surgery, Yokohama-Sakae Kyosai Hospital.
Tanaka
N
N
Mukai
K
K
Fujii
S
S
Kawasuji
M
M
Watanabe
Y
Y
D000328:Adult; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003327:Coronary Disease / Q000601:surgery*; D003329:Coronary Vasospasm / Q000209:etiology* / Q000628:therapy; D003331:Coronary Vessels / Q000601:surgery*; D006336:Heart Massage; D006801:Humans; D008297:Male