Diffuse Coronary Vasospasm After Mitral Valve Replacement, Maze Procedure, and Tricuspid Valve Repair

Andrew J Gorton; Peter Rodgers-Fischl; John Gurley; Johannes Dorfling; Suresh Keshavamurthy

doi:10.7759/cureus.35405

Diffuse Coronary Vasospasm After Mitral Valve Replacement, Maze Procedure, and Tricuspid Valve Repair

Cureus. 2023 Feb 24;15(2):e35405. doi: 10.7759/cureus.35405. eCollection 2023 Feb.

Authors

Andrew J Gorton¹, Peter Rodgers-Fischl¹, John Gurley², Johannes Dorfling³, Suresh Keshavamurthy¹

Affiliations

¹ Department of Surgery, Division of Cardiothoracic Surgery, University of Kentucky, Lexington, USA.
² Department of Cardiovascular Medicine, University of Kentucky, Lexington, USA.
³ Department of Anesthesiology, University of Kentucky, Lexington, USA.

Abstract

Coronary vasospasm is a known complication after coronary artery bypass grafting surgery but has rarely been described in non-coronary cardiac operations. We report the case of a 51-year-old male with nonischemic cardiomyopathy and paroxysmal atrial fibrillation. He presented with severe mitral and tricuspid regurgitation and was taken for mitral valve replacement, tricuspid valve repair, and Maze procedure. Postoperative emergent coronary angiography demonstrated diffuse coronary vasospasm. Injection of intracoronary nitroglycerin led to clinical and angiographic improvement. This demonstrates the possibility of coronary vasospasm following mitral valve replacement and effective treatment with intracoronary administration of vasodilating agents.

Keywords: atrial fibrillation; coronary artery imaging; mitral valve replacement; perioperative care; tricuspid valve.

Publication types

Case Reports