title: [Intraoperative circulatory collapse due to a coronary spasm following successful coronary revascularization].
abstract: Coronary artery spasm is recognized cause of angina and circulatory collapse during the operative and early postoperative period following cardiopulmonary bypass for coronary artery surgery. We present our experience with hemodynamical collapse during cardiopulmonary bypass weaning, which were refractory to treatment with inotropics such as noradrenaline and adrenalin and vasodilators such as nitroglycerin. The electrocardiographic changes, poor answer to medical treatment following successful cardiopulmonary bypass for coronary artery surgery, good myocardial protection and complete revascularization suggested severe coronary artery spasm. We used sublingual nifedipine, achieving hemodynamical stability and stopping inotropic support and cardiopulmonary bypass. We review the literature about pathophysiologic mechanism and treatment of coronary artery spasm.
authors.affiliation: Departamento de Cirugía Cardiovascular, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
authors.forename: M S
authors.initials: MS
authors.lastname: Urrea Ramos
authors.forename: S
authors.initials: S
authors.lastname: Celaya Lara
authors.forename: J A
authors.initials: JA
authors.lastname: Santibáñez Salgado
authors.forename: V
authors.initials: V
authors.lastname: Lozano Torres
authors.forename: V
authors.initials: V
authors.lastname: Herrera Alarcón
authors.forename: S
authors.initials: S
authors.lastname: Estrada Dávalos
authors.forename: F
authors.initials: F
authors.lastname: Rucinque Acevedo
authors.forename: V
authors.initials: V
authors.lastname: Araya Gómez
mesh_terms: D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D003329:Coronary Vasospasm / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D007431:Intraoperative Complications / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage; D005996:Nitroglycerin / Q000008:administration & dosage; D012501:Saphenous Vein / Q000637:transplantation; D012769:Shock / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
chemical_list: D005996:Nitroglycerin; D009543:Nifedipine
vernacular_title: Colapso circulatorio intraoperatorio debido a espasmo coronario después de revascularización coronaria exitosa.