Key result
Coronary vasospasm after MVR can cause profound myocardial ischemia and complicate CPB termination.
Case Report (n=1)
Coronary vasospasm should be considered a potential cause of myocardial insufficiency after cardiopulmonary bypass during valve replacement, even in the absence of coronary artery disease.
Coronary vasospasm merits consideration in unexplained post-bypass ischemia after mitral valve replacement; this case leaves open incidence and management questions.
Coronary artery spasm has been reported as a cause of myocardial ischaemia and necrosis during and after coronary revascularisation [1-4, 9, 11, 13, 14], but not after valve replacement. We report a case in which profound myocardial ischaemia after mitral valve replacement leading to difficulty in terminating cardiopulmonary bypass was caused by coronary vasospasm. It is suggested that coronary vasospasm has to be considered among the causes of myocardial insufficiency after cardiopulmonary bypass, even in the absence of coronary artery disease, and effective treatment may be obtained by coronary vasodilating drugs.
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Shafei et al. (1990) conducted a case report in Myocardial ischaemia after mitral valve replacement (n=1). Mitral valve replacement was evaluated on Myocardial ischaemia and difficulty terminating cardiopulmonary bypass. Coronary vasospasm can cause profound myocardial ischaemia after mitral valve replacement, leading to difficulty in terminating cardiopulmonary bypass.
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