Native coronary artery and grafted artery spasm just after coronary artery bypass grafting: a case report

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Vascular Physiology

Background:

• Coronary artery bypass grafting (CABG) is a common procedure for treating coronary artery disease.
• Post-CABG complications can include graft failure and native vessel issues.
• Coronary artery spasm, though rare, is a serious complication that can lead to hemodynamic instability.

Observation:

• A 72-year-old male presented with symptoms suggestive of coronary artery spasm post-CABG.
• Both native coronary arteries and the grafted artery exhibited spasm.
• The patient experienced circulatory collapse due to the vasospasm.

Findings:

• The case demonstrates a rare instance of simultaneous native and grafted coronary artery spasm after CABG.
• Successful management was achieved through coronary angiography.
• Intracoronary injection of nitroglycerin effectively resolved the vasospasm.

Implications:

• This case highlights the importance of considering coronary artery spasm in patients with circulatory collapse post-CABG.
• Coronary angiography and intracoronary nitroglycerin are effective therapeutic options.
• Further research may elucidate mechanisms and optimize management strategies for this rare complication.