[Perioperative ischemia in coronary surgery caused by coronary spasm of an angiographically normal coronary artery].
Spasm of healthy native coronary arteries is rare but a serious cause of perioperative ischaemia after coronary bypass surgery. The authors report five characteristic cases. In each case, the spasm presented with giant ST elevation and haemodynamic changes. In one case, further coronary bypass surgery was required. In three cases, symptomatic treatment of the hypotension associated with diltiazem completely cured the problem. One case was complicated by a small myocardial infarction. There were no fatalities. Previously reported cases often describe very heavy therapeutic protocols, justified by the high risks of this condition. Due to the fact that it is not possible to identify a target-population, simple prophylactic treatment with diltiazem seems to be justified in patients undergoing coronary artery bypass surgery.
Service de chirurgie cardiaque, centre hospitalier de Mulhouse.
F
F
Panes
Y
Y
Chalet
A
A
Elkouby
P
P
Durasnel
F
F
Razafindrainibe
J P
JP
Monassier
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003327:Coronary Disease / Q000601:surgery*; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications
Ischémie périopératoire en chirurgie coronaire par spasme coronaire sur artère radiologiquement normale.