心脏手术引起的冠状动脉痉挛的一个新方面。

K Kinoshita, K Matsuzaki, H Mayumi, T Asou, M Masuda, Y Kawachi, K Tokunaga
{"title":"心脏手术引起的冠状动脉痉挛的一个新方面。","authors":"K Kinoshita,&nbsp;K Matsuzaki,&nbsp;H Mayumi,&nbsp;T Asou,&nbsp;M Masuda,&nbsp;Y Kawachi,&nbsp;K Tokunaga","doi":"10.1007/BF02470967","DOIUrl":null,"url":null,"abstract":"<p><p>Five patients developed coronary artery spasm during open heart surgery in our institute between 1984 and 1988. One patient was undergoing coronary artery bypass grafting and the other four valvular surgery or surgery for congenital heart disease. In one of the patients undergoing non-coronary surgery, the preoperative induction of right coronary artery spasm by ergonovine had been documented angiographically while the remaining three patients did not possess organic or functional coronary disease. All five patients exhibited a sudden onset of hemodynamic collapse with ventricular tachyarrhythmias or ST elevation during the early period of reperfusion, the time to onset being 89.2 +/- 84.8 minutes after unclamping of the aorta. In addition, contraction of the right ventricular free wall was severely impaired. Although one patient died due to left ventricular rupture caused by direct cardiac massage, the early mortality thus being 20 per cent, the other four were successfully treated with the intravenous administration of nitroglycerin and diltiazem. Three patients required the assistance of intraaortic balloon pumping for severe cardiac failure. Thus, during open heart surgery, coronary artery spasm can occur even in patients without organic coronary lesions and the possible mechanisms of this condition are discussed herein.</p>","PeriodicalId":22610,"journal":{"name":"The Japanese journal of surgery","volume":"21 4","pages":"395-401"},"PeriodicalIF":0.0000,"publicationDate":"1991-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF02470967","citationCount":"10","resultStr":"{\"title\":\"A new aspect of coronary artery spasm induced by cardiac surgery.\",\"authors\":\"K Kinoshita,&nbsp;K Matsuzaki,&nbsp;H Mayumi,&nbsp;T Asou,&nbsp;M Masuda,&nbsp;Y Kawachi,&nbsp;K Tokunaga\",\"doi\":\"10.1007/BF02470967\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Five patients developed coronary artery spasm during open heart surgery in our institute between 1984 and 1988. One patient was undergoing coronary artery bypass grafting and the other four valvular surgery or surgery for congenital heart disease. In one of the patients undergoing non-coronary surgery, the preoperative induction of right coronary artery spasm by ergonovine had been documented angiographically while the remaining three patients did not possess organic or functional coronary disease. All five patients exhibited a sudden onset of hemodynamic collapse with ventricular tachyarrhythmias or ST elevation during the early period of reperfusion, the time to onset being 89.2 +/- 84.8 minutes after unclamping of the aorta. In addition, contraction of the right ventricular free wall was severely impaired. Although one patient died due to left ventricular rupture caused by direct cardiac massage, the early mortality thus being 20 per cent, the other four were successfully treated with the intravenous administration of nitroglycerin and diltiazem. Three patients required the assistance of intraaortic balloon pumping for severe cardiac failure. Thus, during open heart surgery, coronary artery spasm can occur even in patients without organic coronary lesions and the possible mechanisms of this condition are discussed herein.</p>\",\"PeriodicalId\":22610,\"journal\":{\"name\":\"The Japanese journal of surgery\",\"volume\":\"21 4\",\"pages\":\"395-401\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"1991-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1007/BF02470967\",\"citationCount\":\"10\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The Japanese journal of surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/BF02470967\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The Japanese journal of surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/BF02470967","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 10

摘要

1984年至1988年间,本院有5例患者在心内直视手术中发生冠状动脉痉挛。1例为冠状动脉搭桥术,其余4例为瓣膜手术或先天性心脏病手术。其中一名接受非冠状动脉手术的患者,术前用麦角碱诱导右冠状动脉痉挛的血管造影记录在案,而其余三名患者没有器质性或功能性冠状动脉疾病。5例患者均在再灌注早期出现突发性血流动力学塌陷伴室性心动过速或ST段抬高,其发病时间为主动脉解夹后89.2±84.8分钟。此外,右心室游离壁的收缩功能严重受损。虽然一名患者因直接心脏按摩造成左心室破裂而死亡,因此早期死亡率为20%,但其他四名患者通过静脉注射硝酸甘油和地尔硫卓成功治疗。3例严重心力衰竭患者需要主动脉内球囊泵送辅助。因此,在心脏手术中,即使没有器质性冠状动脉病变的患者也可能发生冠状动脉痉挛,本文讨论了这种情况的可能机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
A new aspect of coronary artery spasm induced by cardiac surgery.

Five patients developed coronary artery spasm during open heart surgery in our institute between 1984 and 1988. One patient was undergoing coronary artery bypass grafting and the other four valvular surgery or surgery for congenital heart disease. In one of the patients undergoing non-coronary surgery, the preoperative induction of right coronary artery spasm by ergonovine had been documented angiographically while the remaining three patients did not possess organic or functional coronary disease. All five patients exhibited a sudden onset of hemodynamic collapse with ventricular tachyarrhythmias or ST elevation during the early period of reperfusion, the time to onset being 89.2 +/- 84.8 minutes after unclamping of the aorta. In addition, contraction of the right ventricular free wall was severely impaired. Although one patient died due to left ventricular rupture caused by direct cardiac massage, the early mortality thus being 20 per cent, the other four were successfully treated with the intravenous administration of nitroglycerin and diltiazem. Three patients required the assistance of intraaortic balloon pumping for severe cardiac failure. Thus, during open heart surgery, coronary artery spasm can occur even in patients without organic coronary lesions and the possible mechanisms of this condition are discussed herein.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
The 73rd Annual Meeting of the Japan Surgical Society The 74th Annual Meeting of the Japan Surgical Society The beginnings of a “human science” The general rules for the gastric cancer study in surgery and pathology The 75th Annual Meeting of the Japan Surgical Society
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1