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Surgical Porcine Model of Chronic Myocardial Ischemia Treated by Exosome-laden Collagen Patch and Off-pump Coronary Artery Bypass Graft
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[Coronary vasospasm during off-pump coronary artery bypass grafting; report of two cases]

S Yoshida1, K Sakuma, H Yokoyama

  • 1Department of Cardiovascular Surgery, Chiba Tokushukai Hospital, Funabashi, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|July 12, 2003
PubMed

Insights

Coronary vasospasm is a serious risk during off-pump coronary artery bypass grafting (CABG). Vigilance is crucial, as prompt intervention is vital for managing these dangerous cardiac events.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Anesthesia

Background:

  • Coronary artery bypass grafting (CABG) is a common procedure for coronary artery disease.
  • Off-pump CABG (OPCAB) aims to reduce invasiveness compared to conventional CABG.
  • Coronary vasospasm remains a significant, potentially fatal complication in cardiac surgery.

Observation:

  • Two cases of coronary vasospasm during OPCAB are presented.
  • Case 1 involved a 63-year-old male with 3-vessel disease experiencing ST elevation and ventricular fibrillation.
  • Case 2 involved a 67-year-old male experiencing ST elevation and complete atrio-ventricular block.

Findings:

  • Both patients underwent OPCAB using left internal thoracic artery (LITA) and radial artery grafts.
  • Immediate interventions including intra-aortic balloon pumping (IABP) and percutaneous cardiopulmonary support (PCPS) were necessary.
  • Additional grafting and ventricular pacing were employed based on the specific complications observed.

Implications:

  • OPCAB, while less invasive, does not eliminate the risk of coronary vasospasm.
  • Increased awareness and preparedness for managing coronary vasospasm during OPCAB are essential.
  • Prompt recognition and intervention are critical for improving patient outcomes in these complex cases.

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