Intraoperative cardiac arrest caused by unexpected vasospastic angina requiring prolonged resuscitation using extracorporeal membrane oxygenation: a case report.

Pub Date : 2023-11-09 DOI:10.1186/s40981-023-00667-z

Shinji Sugita, Masanobu Obata, Fumihiko Hasunuma, Atsuhiro Sakamoto

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Abstract

Background: Vasospastic angina (VSA) occurring during surgery is rare but can lead to sudden intraoperative cardiac arrest.

Case presentation: A 77-year-old man with hypertension, and no history of coronary artery disease, displayed an abrupt ST-segment elevation on the electrocardiogram (ECG) during laparoscopic inguinal hernia surgery under general anesthesia. Subsequently, ventricular fibrillation (VF) occurred, with a finding suggesting ischemic myocardial contracture by transesophageal echocardiography. VF was refractory to cardiopulmonary resuscitation (CPR), and veno-arterial extracorporeal membrane oxygenation (VA ECMO) was introduced. Spontaneous circulation resumed 77 min post-cardiac arrest. VSA was confirmed through the patient's clinical course and coronary angiography. Subsequently, VA ECMO was terminated, and the patient was discharged uneventfully.

Conclusions: Extracorporeal CPR may be a valuable alternative to extended resuscitation for refractory ventricular arrhythmias by VSA.

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意外血管痉挛性心绞痛导致术中心脏骤停，需要使用体外膜肺氧合进行长时间复苏：一例报告。

背景：血管痉挛性心绞痛（VSA）在手术中发生的情况很少见，但会导致术中心脏骤停。病例介绍：一名77岁男性，患有高血压，无冠状动脉病史，在全麻下腹腔镜腹股沟疝手术中，心电图（ECG）显示ST段突然升高。随后，心室颤动（VF）发生，经食道超声心动图显示缺血性心肌挛缩。VF对心肺复苏（CPR）是难治的，并引入了静脉-动脉体外膜肺氧合（VA ECMO）。心脏骤停后77分钟，自发循环恢复。通过患者的临床病程和冠状动脉造影证实了VSA。随后，VA ECMO终止，患者顺利出院。结论：体外心肺复苏术可能是VSA延长难治性室性心律失常复苏的一种有价值的替代方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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