Treatment of refractory coronary vasospasm during cardiopulmonary bypass with compulsory coronary perfusion

Coronary vasospasm is still a devastating complication during cardiac surgery. We report on a case of intractable coronary vasospasm in a 45-year-old male during coronary bypass surgery refractory to drugs and intra-aortic balloon pumping (IABP). Under cardiopulmonary bypass (CPB) support, the aorta was again cross-clamped and the aortic root was compulsorily perfused with pump blood using a small pump for infusion of cardioplegia. Vasodilators were administered through the perfusion line. Coronary vasospasm was dramatically resolved. He was then successfully weaned from CPB and recovered without further incidents.