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Related Experiment Videos

[Coronary bypass surgery using arterial conduit and its pitfall].

T Fujiwara1, H Yamane, H Yoshida

  • 1Department of Thoracic Surgery, Kawasaki Medical School.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|August 1, 1992
PubMed
Summary

Severe arterial graft spasm after coronary bypass surgery can cause critical complications. Promptly adding a saphenous vein graft may improve outcomes in such cases.

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Area of Science:

  • Cardiovascular Surgery
  • Vascular Biology

Background:

  • Coronary artery bypass grafting (CABG) is a common procedure.
  • Arterial grafts are increasingly used for improved long-term patency.
  • Graft spasm can compromise immediate surgical success.

Observation:

  • Three patients experienced immediate severe spasm of internal mammary and gastroepiploic arteries post-CABG.
  • Doppler velocimetry showed absent diastolic flow in spastic grafts.
  • Patients required additional saphenous vein grafts to wean from cardiopulmonary bypass.

Findings:

  • Intractable arterial graft spasm led to hemodynamic instability.
  • Despite interventions, two of three patients died postoperatively.
  • Sufficient initial flow and technically adequate anastomoses were confirmed.

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Implications:

  • Profound arterial conduit spasm necessitates urgent management.
  • Consider intraoperative saphenous vein grafting for intractable spasm.
  • Early graft failure and mortality are risks associated with severe spasm.