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Successful A-C bypass operation in patient with vasospaslic angina: evaluation with coronary circulation during attack Jun Tamai 1 , Shinsuke Nanto 1 , Kiyomu Ishikawa 1 , Yukihiro Koretsune 1 , Kazuhisa Kodama 1 , Jun-ichi Sumimura 2 , Masa-aki Nakahara 2 , Seizo Nakata 2 , Masahiro Yokota 2 1Cardiac Intensive Care Unit of Osaka Police Hospital 2Department of Cardiovascular Surgery of Osaka Police Hospital pp.1207-1211
Published Date 1984/11/15
DOI https://doi.org/10.11477/mf.1404204556
  • Abstract
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A patient with ST-T segment elevation in chest leads of EC'G during anginal attack became asymp-tomatic after a 90% left anterior descending coronary artery (LAD) stenosis was bypassed.

Pre- and post-operation, ergonovine maleate (EM) was provocated for investigation of angina from the view points of coronary angiography, coronary hemodynamics and myocardial me-tabolism.

In pre-operative study, EM induced ST-T ele-vation in chest leads associated with chest pain, and coronary angiography showed coronary arterial spasm at the fixed lesion of LAD.

Coronary vascular resistance, lactate extraction ratio and cardiac output were decreased and pulmonary arterial end diastolic pressure was increased by EM. Angiographically, good patency of graft and peripheral perfusion of LAD were shown instead of remaining coronary arterial spasm at the same portion. No remarkable change was presented in coronary hemodynamics and myo-cardial metabolism.

we conclude that aorto-coronary bypass surgery is effective for the patients with vasospastic angina associated with coronary arterial stenosis not only from the view point of coronary angiography but coronary hemodynamics and myocardial metabo-lism.


Copyright © 1984, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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