Relief of vasospasm with fasudil after off-pump coronary artery bypass grafting: a case study

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Pharmacology

Background:

• Coronary vasospasm post-coronary artery bypass grafting (CABG) is a rare but critical complication.
• It frequently resists conventional vasodilator therapies.
• This highlights a significant challenge in cardiac surgery patient management.

Purpose of the Study:

• To report a case of refractory coronary vasospasm following CABG.
• To evaluate the efficacy of fasudil in treating this condition.
• To assess fasudil's safety profile in this context.

Main Methods:

• A 74-year-old female patient underwent CABG for severe left anterior descending artery stenosis.
• Post-anastomosis, refractory coronary vasospasm was diagnosed via angiography.
• Fasudil, a Rho kinase inhibitor, was administered intravenously.

Main Results:

• Conventional vasodilators failed to resolve the coronary vasospasm.
• Fasudil injection successfully relieved the vasospasm.
• No systemic hypotension was observed following fasudil administration.

Conclusions:

• Fasudil demonstrates potential as a crucial vasodilator for managing post-CABG coronary vasospasm.
• It offers a viable treatment option when standard vasodilators are ineffective.
• Further investigation into fasudil's role in similar cases is warranted.