Sympathectomy versus conventional treatment for refractory coronary artery spasm

Lin, Yaowang; Liu, Huadong; Yu, Dan-qing; Wu, Minna; Liu, Qiyun; Liang, Xinjian; Pang, Xinli; Chen, Keqi; Luo, Lan; Dong, Shaohong

doi:10.1097/mca.0000000000000732

Cited by 11 publications

(7 citation statements)

References 25 publications

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“…Current literature on its application to CAS is limited, but most of them implied the resolution of all symptoms without major complications. Lin et al [5] published the so far largest series that implied the reduction of major adverse cardiac event compared with the conventional treatment, which is consistent with previous reports.…”

Section: Discussionsupporting

confidence: 85%

Bilateral thoracic sympathectomy for refractory coronary artery spasm—A case report

Lee,

Chen,

et al. 2024

Formos J Surg

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A 51-year-old woman was admitted due to 3rd degree AV block. Serial coronary angiogram revealed right coronary artery (RCA) spasm, which is refractory to drug eluting stents and NTG infusion. She underwent bilateral cardiac sympathetic denervation (BCSD) with video-assisted thoracoscopic surgery (VATS), and was discharged on day 26 asymptomatically. BCSD could be used for patients with symptomatic coronary artery spasm.

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Section: Discussionsupporting

confidence: 85%

Bilateral thoracic sympathectomy for refractory coronary artery spasm—A case report

Lee,

Chen,

et al. 2024

Formos J Surg

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“…Thoracic chain resection was performed with VATS method in our patient because of the recurrence of CAVS despite all other therapies. Since 1980s, the sympathectomy has been shown to be successful in cases of resistant vasospastic angina (11). In a study, sympathectomy led to the resolution of all symptoms including pulseless electrical activity and cardiac arrest, and it was shown to prevent recurrence of angina and arrhythmia (12).…”

Section: Main Pointsmentioning

confidence: 99%

Aggressive Treatment of Refractory Coronary Artery Vasospasm in a Patient with Malignant Ventricular Tachyarrhythmia and Cardiac Arrest

Doğan¹,

Kaya²,

Deniz³

et al. 2023

Eur J Ther

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Coronary artery vasospasm (CAVS) is a clinical entity that can cause angina, but also unstable angina pectoris, acute myocardial infarction, fatal arrhythmias, and sudden death. Although it is a condition that is usually controlled with medical treatment, more aggressive treatments may rarely be required. In this case, the patient with a known diagnosis of CAVS had multiple arrests despite optimal medical treatment. We observed that fatal arrhythmias persisted in the Implantable Cardioverter Defibrillator (ICD) records, even though we implanted a stent and gave the patient maximal medical treatment. We performed sympathectomy as a last resort and we did not detect any recurrence in the 6-month follow-up of the patient. ICD implantation and sympathectomy should always be considered in resistant CAVS cases.

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“…A study by Lin et al [ 84 ] shows another potential treatment option for refractory CAS—sympathectomy. The study showed that sympathectomy, compared to traditional CAS treatment, was more effective in protecting against a syndrome of episodes of a major adverse cardiac event and death.…”

Section: Management Of Coronary Artery Spasmmentioning

confidence: 99%

“…The study showed that sympathectomy, compared to traditional CAS treatment, was more effective in protecting against a syndrome of episodes of a major adverse cardiac event and death. However, the authors emphasize that further studies are needed [ 84 ].…”

Section: Management Of Coronary Artery Spasmmentioning

confidence: 99%

Cellular Mechanisms of Coronary Artery Spasm

et al. 2022

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Coronary artery spasm (CAS) is a reversible phenomenon caused by spontaneous excessive vascular smooth muscle contractility and vascular wall hypertonicity, which results in partial or complete closure of the lumen of normal or atherosclerotic coronary arteries. The clinical picture of CAS includes chest discomfort which is similar in quality to that of stable effort angina. Mechanisms underlying the development of CAS are still unclear. CAS certainly is a multifactorial disease. In this review, we paid attention to the role of the main pathophysiologic mechanisms in CAS: endothelial dysfunction, chronic inflammation, oxidative stress, smooth muscle hypercontractility, atherosclerosis and thrombosis, and mutations leading to deficient aldehyde dehydrogenase 2 (ALDH2) activity. These findings might shed novel insight on the underlying mechanisms and identify potential diagnostic and therapeutic targets for cardiovascular diseases in the future.

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Sympathectomy versus conventional treatment for refractory coronary artery spasm

Cited by 11 publications

References 25 publications

Bilateral thoracic sympathectomy for refractory coronary artery spasm—A case report

Bilateral thoracic sympathectomy for refractory coronary artery spasm—A case report

Aggressive Treatment of Refractory Coronary Artery Vasospasm in a Patient with Malignant Ventricular Tachyarrhythmia and Cardiac Arrest

Cellular Mechanisms of Coronary Artery Spasm

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