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

IF 0.8 Q3 ANESTHESIOLOGY JA Clinical Reports 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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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.