Temporary left ventricular assist and levosimendan for coronary artery spasm.
Coronary vasospasm is a life threatening complication in the early postoperative period after coronary artery bypass grafting. We report a 45-year-old patient with normal preoperative ventricular function who could not be stabilized using established treatments such as: systemic application of glyceryl trinitrate, diltiazem and milrinone, intraaortic balloon pumping and intracoronary injection of glyceryl trinitrate. Severe stunning of the myocardium required support with a centrifugal left ventricular assist device. Subsequent application of levosimendan, a calcium sensitizer, may have contributed to prevent recurrence of repeated episodes of coronary spasm, enabling early explantation of the assist device and a full recovery.
Döpfmer
Ulrich R
UR
Department of Anesthesiology and Surgical Intensive Care, Charité University Hospital, Campus Mitte, Schumannstrasse 20-21, 10117 Berlin, Germany. doepfmer@snafu.de
Braun
Jan P
JP
Grosse
Joachim
J
Konertz
Wolfgang
W