Related Experiment Video

Updated: Mar 29, 2026

Author Spotlight: Enhancing Coronary Artery Revascularization
05:25

Author Spotlight: Enhancing Coronary Artery Revascularization

Published on: September 15, 2023

1.4K

Spasm in Arterial Grafts in Coronary Artery Bypass Grafting Surgery

Guo-Wei He1, David P Taggart2

  • 1Department of Cardiovascular Surgery and Center for Basic Medical Research, TEDA International Cardiovascular Hospital, Tianjin, and the Affiliated Hospital of Hangzhou Normal University and Zhejiang University, Hangzhou, China; Department of Surgery, Oregon Health and Science University, Portland, Oregon.

The Annals of Thoracic Surgery
|November 22, 2015
PubMed

Insights

Arterial graft spasm during coronary artery bypass grafting (CABG) is a serious issue. This review discusses mechanisms, diagnosis via angiography, and treatments like vasodilators to manage this potentially lethal complication.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Biology
  • Clinical Medicine

Background:

  • Arterial graft spasm is a significant clinical problem in coronary artery bypass grafting (CABG) surgery.
  • Refractory spasm can be lethal, with perioperative spasm reported in 0.43% of CABG surgeries, potentially an underestimate.
  • Spasm occurs in various grafts, including internal mammary, right gastroepiploic, and radial arteries.

Purpose of the Study:

  • To review the mechanisms, diagnosis, and management of arterial graft spasm in CABG.
  • To highlight the clinical significance and potential lethality of refractory graft spasm.
  • To discuss preventive strategies for arterial graft spasm.

Main Methods:

  • Review of existing literature on arterial graft spasm in CABG.
  • Discussion of pathophysiological pathways, including intracellular calcium regulation and endothelial dysfunction.
  • Emphasis on diagnostic methods like angiography and therapeutic interventions.

Main Results:

  • Spasm mechanisms involve intracellular calcium regulation and endothelial dysfunction.
  • Angiography is crucial for confirming spasm during or after CABG.
  • Intraluminal vasodilators are effective, with other interventions like intraaortic balloon pump or ECMO as potential salvage options.

Conclusions:

  • Arterial graft spasm is a critical complication in CABG requiring prompt recognition and management.
  • Understanding the underlying mechanisms is key to developing effective prevention and treatment strategies.
  • Multifaceted approaches, including pharmacological and mechanical interventions, are necessary for patient salvage.

More Related Videos

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery09:12

Surgical Swine Model of Chronic Cardiac Ischemia Treated by Off-Pump Coronary Artery Bypass Graft Surgery

Published on: March 27, 2018

10.0K
Arterial Pouch Microsurgical Bifurcation Aneurysm Model in the Rabbit06:11

Arterial Pouch Microsurgical Bifurcation Aneurysm Model in the Rabbit

Published on: May 14, 2020

2.9K

Related Concept Videos

Vascular Spasm01:16

Vascular Spasm

The vascular phase, also known as vasospasm, is the initial stage of hemostasis, crucial for preventing excessive bleeding when a blood vessel is injured. After a vessel is cut, nerves in the damaged area trigger pain and other sensory impulses. Simultaneously, the smooth muscles in the vessel wall contract, resulting in a vascular spasm. This contraction reduces the vessel's diameter at the injury site, slowing or stopping blood loss through the vessel wall. Vascular spasms typically last...
4.8K
Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
582
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
449
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
566