HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lemmer, J. H. Articles by Kirsh, M. M. Search for Related Content PubMed PubMed Citation Articles by Lemmer, J. H., Jr Articles by Kirsh, M. M.

The Annals of Thoracic Surgery, Vol 46, 108-115, Copyright © 1988 by The Society of Thoracic Surgeons

ARTICLES

Coronary artery spasm following coronary artery surgery

JH Lemmer Jr and MM Kirsh
Division of Cardiothoracic Surgery, University of Iowa Hospital, Iowa City.

Coronary artery spasm during the early postoperative period following cardiopulmonary bypass for coronary artery surgery can be an unrecognized cause of sudden, severe cardiopulmonary collapse. The literature regarding perioperative coronary artery spasm is reviewed, and methods of prevention, diagnosis, and treatment are suggested. Preoperative angina at rest appears to be an important identifying factor in patients who experience postoperative coronary spasm. Anatomically, the presence of a relatively normal, dominant right coronary may also indicate increased risk for early post-coronary bypass spasm. Acute hypotension is often the first sign of coronary artery spasm, and conventional treatment methods may only worsen the vasospastic reaction. Peripheral intravenous nitroglycerin infusion has often been unsuccessful treatment while intragraft or intracoronary nitroglycerin injection or administration of calcium channel-blocking drugs, or both, has proven to be effective in reversing the coronary artery spasm and ventricular dysfunction. Reluctance to use vasodilating agents must be overcome, even in the face of hypotension, when evidence of spasm is present.

This article has been cited by other articles:

				U. R. Dopfmer, J. P. Braun, J. Grosse, and W. Konertz Temporary left ventricular assist and levosimendan for coronary artery spasm Interactive CardioVascular and Thoracic Surgery, August 1, 2005; 4(4): 316 - 318. [Abstract] [Full Text] [PDF]

				M. H. Kown, M. A. Lijkwan, C. L. Jahncke, S. Murata, J. B. Rothbard, and R. C. Robbins L-arginine polymers enhance coronary flow and reduce oxidative stress following cardiac transplantation in rats J. Thorac. Cardiovasc. Surg., October 1, 2003; 126(4): 1065 - 1070. [Abstract] [Full Text] [PDF]

				H. B. Bittner Coronary artery spasm and ventricular fibrillation after off-pump coronary surgery Ann. Thorac. Surg., January 1, 2002; 73(1): 297 - 300. [Abstract] [Full Text] [PDF]

				K. E. Al-Ebrahim and H. Shafei Unexpected complications of postcoronary operation: the role of intracoronary ultrasound Ann. Thorac. Surg., March 1, 1999; 67(3): 892 - 893. [Full Text] [PDF]

				M. B. Vroom Pharmacologic Management of Acute Heart Failure: A Review Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 1998; 2(3): 191 - 203. [Abstract] [PDF]

				H. S. Paterson, M. W. Jones, D. K. Baird, and C. F. Hughes Lethal Postoperative Coronary Artery Spasm Ann. Thorac. Surg., June 1, 1998; 65(6): 1571 - 1573. [Abstract] [Full Text] [PDF]

				F. W. Sellke, E. M. Boyle Jr, and E. D. Verrier Endothelial Cell Injury in Cardiovascular Surgery: The Pathophysiology of Vasomotor Dysfunction Ann. Thorac. Surg., October 1, 1996; 62(4): 1222 - 1228. [Abstract] [Full Text]

				Z.-G. Zhu, M.-S. Wang, Z.-B. Jiang, Z. Jiang, S.-X. Xu, C.-Y. Ren, and M.-X. Shi The dynamic change of plasma endothelin-1 during the perioperative period in patients with rheumatic valvular disease and secondary pulmonary hypertension J. Thorac. Cardiovasc. Surg., November 1, 1994; 108(5): 960 - 968. [Abstract] [Full Text]