Coronary artery spasm during mitral valve replacement.
Coronary artery spasm has been reported as a cause of myocardial ischaemia and necrosis during and after coronary revascularisation [1-4, 9, 11, 13, 14], but not after valve replacement. We report a case in which profound myocardial ischaemia after mitral valve replacement leading to difficulty in terminating cardiopulmonary bypass was caused by coronary vasospasm. It is suggested that coronary vasospasm has to be considered among the causes of myocardial insufficiency after cardiopulmonary bypass, even in the absence of coronary artery disease, and effective treatment may be obtained by coronary vasodilating drugs.
National Heart Hospital, London, UK.
H
H
Shafei
J G
JG
Bennett
D000792:Angiography; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D003329:Coronary Vasospasm / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D004874:Ergonovine; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D012214:Rheumatic Heart Disease / Q000150:complications
D004874:Ergonovine