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Updated: Apr 26, 2026

Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Coronary artery spasm following off-pump coronary artery bypass surgery
Shinya Unai1, Hitoshi Hirose, Gary Cook
1Division of Cardiothoracic Surgery, Department of Surgery, Thomas Jefferson University.
Insights
Coronary artery spasm following bypass surgery can be fatal. Early diagnosis and management of this condition, coronary vasospasm, are crucial for preventing severe complications and ensuring patient survival.
Area of Science:
- Cardiology
- Cardiac Surgery
Background:
- Coronary artery bypass surgery (CABS) is a common procedure for coronary artery disease.
- Postoperative complications can significantly impact patient outcomes.
Observation:
- Two cases of coronary artery spasm (CAS) occurring after CABS are presented.
- One patient experienced ventricular fibrillation, necessitating extracorporeal membrane oxygenation (ECMO).
Findings:
- CAS can manifest as sudden hemodynamic compromise post-CABS.
- Prompt recognition and intervention are key to managing CAS.
Implications:
- Coronary vasospasm should be considered in the differential diagnosis of unexpected circulatory issues after CABS.
- Timely management of CAS can prevent life-threatening events and improve patient prognosis.
Abstract:
Coronary artery spasm after coronary artery bypass surgery may result in life-threatening arrhythmias, circulatory collapse, or death. We report two cases of coronary artery spasm after coronary artery bypass surgery, one of which developed ventricular fibrillation requiring extracorporeal membrane oxygenation support. Both patients were discharged in good condition and are currently followed as outpatients. Unexpected sudden hemodynamic compromise could be due to coronary vasospasm, and this should be considered as one of the possible differential diagnoses. We were able to prevent the lethal consequences seen with coronary artery spasm by early diagnosis and management.
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