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Korean J Transplant 2022; 36(2): 154-158

Published online June 30, 2022

https://doi.org/10.4285/kjt.22.0006

© The Korean Society for Transplantation

Intractable right coronary artery spasm in the early postoperative period after heart transplantation: a case report

Jaewook Chung1 , Jeehoon Kang1,2 , Hae-Young Lee1 , Suk Ho Sohn3 , Ho Young Hwang3 , Hyun-Jai Cho1

1Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
2Department of Critical Care Medicine, Seoul National University Hospital, Seoul, Korea
3Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea

Correspondence to: Jeehoon Kang
Department of Critical Care Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
Tel: +82-2-2072-2677
Fax: +82-2-766-8904
E-mail: medikang@gmail.com

Received: February 7, 2022; Revised: April 16, 2022; Accepted: April 18, 2022

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Coronary artery spasm after heart transplantation is a very rare complication. In one observational study and many anecdotal reports, most cases of coronary artery spasm occurred more than 1 year after surgery and had good outcomes. However, cases of intractable coronary artery spasm during the early postoperative period resulting in fatality are limited. This report presents a case of two cardiac arrests caused by coronary artery spasms within a short period of time after heart transplantation.

Keywords: Heart transplantation, Coronary vasospasm, Coronary angiography, Intravascular ultrasound, Myocardial revascularization, Case reports

HIGHLIGHTS
  • A severe and intractable coronary artery spasm can cause death during the early postoperative period after cardiac transplantation.

  • Stent implantation for coronary spasm should be carefully determined in clinical practice.

  • Donor heart coronary evaluation might be helpful for detecting coronary atherosclerosis and vasoreactivity of the recipient heart before heart transplantation.