title: Postoperative diffuse coronary spasm after two valve surgery - a rare phenomenon.
abstract: Postoperative coronary artery spasm is one of the grave complications of cardiac surgery and is usually seen in patients undergoing coronary artery bypass surgery. We describe the case of a 63 year old male patient developing postoperative spasm of the entire coronary tree after aortic & mitral valve replacement, manifesting as significant electrocardiographic changes. Urgent coronary angiography was performed which revealed diffuse spasm of the entire coronary tree. It resolved completely with intracoronary injection of Nitroglycerine. The present case highlights the likelihood of postoperative coronary spasm even after valve replacement surgery, and not just coronary bypass surgery. It also illustrated the usefulness of coronary angiography for both diagnosis and treatment of this entity.
authors.affiliation: Department of Cardiothoracic Surgery, Sagar Hospital-DSI, Banshankari, Bangalore 560078, India. Electronic address: drtanveerahmad@gmail.com.
authors.forename: Tanveer
authors.initials: T
authors.lastname: Ahmad
authors.affiliation: Department of Cardiology, Sagar Hospital-DSI, Banshankari, Bangalore 560078, India.
authors.forename: Kolkebaile Sadanand
authors.initials: KS
authors.lastname: Kishore
authors.affiliation: Department of Anaesthesia, Sagar Hospital-DSI, Banshankari, Bangalore 560078, India.
authors.forename: Nandakumar Neralakere
authors.initials: NN
authors.lastname: Maheshwarappa
authors.affiliation: Department of Cardiothoracic Surgery, Sagar Hospital-DSI, Banshankari, Bangalore 560078, India.
authors.forename: Ashwini Kumar
authors.initials: AK
authors.lastname: Pasarad
mesh_terms: D001021:Aortic Valve / Q000002:abnormalities* / Q000601:surgery; D000082882:Bicuspid Aortic Valve Disease; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D003331:Coronary Vessels; D004562:Electrocardiography; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage; D011183:Postoperative Complications; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin
keywords: Diffuse coronary spasm; Double valve replacement; Intracoronary nitroglycerine; Postoperative coronary spasm