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Coronary artery spasm following on-pump coronary artery bypass grafting with 20 months follow-up

Adam R Kowalówka1, Marcin Malinowski1, Magdalena Onyszczuk1

  • 1Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland.

Kardiochirurgia I Torakochirurgia Polska = Polish Journal of Cardio-Thoracic Surgery
|January 19, 2017
PubMed

Insights

This case study details a 69-year-old woman experiencing coronary artery spasm after coronary artery bypass grafting. Prompt treatment with vasodilators and intraaortic balloon pump support led to successful recovery.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery

Background:

  • Coronary artery bypass grafting (CABG) is a common surgical procedure.
  • Postoperative coronary artery spasm (CAS) can lead to serious complications.

Observation:

  • A 69-year-old female patient developed native and grafted vessel spasm after on-pump CABG.
  • Electrocardiogram (ECG) abnormalities persisted despite intraaortic balloon pump (IABP) insertion.

Findings:

  • Emergency coronary angiography (CAG) confirmed CAS.
  • Systemic and intracoronary vasodilator administration, alongside IABP, resolved ECG changes and stabilized hemodynamics.
  • The patient was discharged in good condition after 48 hours of IABP support.

Implications:

  • CAS is a critical postoperative complication with multifactorial causes.
  • CAG is the gold standard for diagnosing CAS.
  • Vasodilators and IABP are effective treatments, with extracorporeal membrane oxygenation reserved for refractory cases.

Keywords:
coronary angiogramcoronary artery bypass graftingcoronary artery spasmon-pump cardiac surgery

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