[Perioperative coronary spasm in the modified Bentall's operation for localized dissecting aneurysm of Valsalva sinuses].
A 55-year-old man had suffered from chest oppression while asleep for 1 to 2 years. Moderate aortic regurgitation and aneurysm of Valsalva sinuses were revealed by echocardiography. It was diagnosed as chronic localized dissecting aneurysm of Valsalva sinuses during the operation, and modified Bentall's operation was performed. The patient was extubated 2 hours after the operation. ST segment depression in leads I, aV(L) and V3-V6, and elevation in leads III and aV(R) suddenly occurred 5 hours after the operation. However, hemodynamics was very stable, and he complained of no chest pain. Cardiac asystole was detected 7 hours after the operation, and percutaneous cardiopulmonary support as well as intraaortic balloon pumping (IABP) was immediately started. Emergency coronary angiography revealed acute myocardial infarction due to severe coronary spasm in the left coronary artery. The patient expired on the 3rd postoperative day.
Sekine
Y
Y
Department of Cardiovascular Surgery, Shizuoka General Hospital, Shizuoka, Japan.
Kitano
M
M
Akimoto
T
T
Matsuda
K
K
D000784:Aortic Dissection / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods; D002908:Chronic Disease; D003329:Coronary Vasospasm / Q000209:etiology*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000628:therapy; D011183:Postoperative Complications / Q000209:etiology; D012850:Sinus of Valsalva