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Coronary-artery spasm after coronary artery bypass graft surgery without extracorporeal circulation: diagnostic and

Joaquim David Carneiro Neto1, José Antonio de Lima Neto, Rosa Maria da Costa Simões

  • 1Hospital Beneficência Portuguesa, São Paulo, Brazil. davidc.neto @ gmail.com

Revista Brasileira De Cirurgia Cardiovascular : Orgao Oficial Da Sociedade Brasileira De Cirurgia Cardiovascular
|November 25, 2010
PubMed

Insights

Coronary artery spasm is a dangerous complication after coronary artery bypass graft surgery. Prompt treatment with intracoronary vasodilators successfully resolved the spasm, stabilizing the patient.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Vascular Medicine

Background:

  • Coronary artery spasm is a critical perioperative complication in coronary artery bypass graft (CABG) surgery, associated with significant mortality.
  • Minimally invasive CABG without extracorporeal circulation presents unique challenges and potential complications.

Observation:

  • A 51-year-old patient undergoing CABG without extracorporeal circulation developed perioperative myocardial injury, indicated by enzymatic alterations and ST-elevation on postoperative day 1.
  • The patient subsequently experienced ventricular fibrillation, which was successfully treated with defibrillation.
  • Cardiac catheterization revealed severe spasm in all coronary arteries and the arterial anastomosis.

Findings:

  • Treatment with intracoronary vasodilators administered directly into the coronary arteries and the graft successfully relieved the spasm.
  • The intervention led to the immediate restoration of normal coronary artery and graft caliber.
  • The patient's clinical and hemodynamic status improved significantly following vasodilator therapy.

Implications:

  • Intracoronary vasodilator administration is an effective treatment for acute coronary artery spasm occurring after CABG surgery.
  • This therapeutic approach can rapidly restore coronary blood flow and improve patient outcomes.
  • Early recognition and intervention are crucial for managing this life-threatening complication in cardiac surgery patients.

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