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Intraoperativer Koronarspasmus mit funktionellem Herzstillstand

Kardiologische Akutintervention

Intraoperative coronary artery spasm with cardiac arrest

Cardiologic acute intervention

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Zusammenfassung

Bei einem 63-jährigen Patienten trat intraoperativ während einer laparoskopisch assistierten Rektumresektion Kammerflimmern auf. Als Ursache konnte ein Koronarspasmus festgestellt werden. Mit einer intrakoronaren Nitroglyzerininjektion konnte der Koronarspasmus aufgehoben und stabile Kreislaufverhältnisse konnten wiederhergestellt werden. Eine hervorragende interdisziplinäre Zusammenarbeit sowie günstige zeitliche und räumliche Voraussetzungen ermöglichten das Outcome des Patienten ohne neurologische Defizite. Neben der Darstellung des konkreten Behandlungsverlaufs werden mögliche, zugrunde liegende Pathomechanismen dargestellt.

Abstract

Ventricular fibrillation occurred intraoperatively during a laparoscopy-assisted resection of the rectum in a 63-year-old patient. A coronary artery spasm was identified as the cause. It was possible to rectify the coronary artery spasm and restore a stable circulatory situation with an intracoronary injection of nitroglycerine. Excellent interdisciplinary cooperation combined with favourable timing and spatial conditions, made this outcome possible for the patient without neurological deficits. In addition to presenting the actual treatment procedure, possible underlying pathogenetic mechanisms will also be presented.

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Fiderer, W., Grosse, W. & Biscoping, J. Intraoperativer Koronarspasmus mit funktionellem Herzstillstand. Anaesthesist 57, 255–261 (2008). https://doi.org/10.1007/s00101-007-1295-5

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