Internal mammary revascularization in patients with variant angina and normal coronary arteries

Area of Science:

• Cardiology
• Vascular Surgery

Background:

• Variant angina (Prinzmetal's angina) refractory to medical therapy presents significant management challenges.
• Coronary revascularization is typically contraindicated in isolated coronary spasm without obstructive disease.

Purpose of the Study:

• To evaluate the efficacy of coronary artery bypass surgery with internal mammary artery (IMA) grafts in patients with medically intractable Prinzmetal's angina and normal coronary arteries.

Main Methods:

• Two patients with life-threatening, intractable Prinzmetal's angina and normal coronary arteries underwent coronary artery bypass surgery using IMA grafts.
• Postoperative angiography was performed to assess graft function during spastic attacks.

Main Results:

• Both patients experienced rapid and complete remission of coronary spastic attacks following surgery.
• Postoperative angiography demonstrated the functional mechanism of the IMA graft during coronary artery spasm.

Conclusions:

• Coronary artery bypass surgery with IMA grafts can be a successful treatment for patients with isolated coronary spasm and normal coronary arteries.
• This surgical approach provides a viable alternative for managing severe, refractory variant angina.