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Updated: Dec 15, 2025

Author Spotlight: Enhancing Coronary Artery Revascularization
Published on: September 15, 2023
Massive coronary spasm of the native coronary system after coronary artery bypass grafting: Two patients with
Matej Ondrusek1, Panagiotis Artemiou1, Ivan Glonek1
1Department of Cardiac Surgery, Faculty of Medicine, National Institute of Cardiovascular Diseases, Comenious University, Bratislava, Slovakia.
Insights
Coronary artery spasm after bypass grafting can occur, with varied outcomes. Prompt treatment with nitroglycerin and calcium channel blockers improved one patient, while another experienced fatal complications despite extracorporeal membrane oxygenation.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Critical Care Medicine
Background:
- Coronary artery bypass grafting (CABG) is a common procedure for coronary artery disease.
- Postoperative complications can significantly impact patient outcomes.
- Native coronary artery spasm is a rare but serious complication following CABG.
Abstract:
We report the cases of two patients who developed a massive spasm of the native coronary system in the immediate postoperative period, following a coronary artery bypass grafting operation with different outcomes. The first patient was hemodynamic stable and it was manifested as ischemic electrocardiographic changes in different leads (ST elevation or depression). He was treated with intracoronary and intravenous administration of nitroglycerin and calcium channel blocker and had a favorable outcome. The second patient died due to multiorgan failure and hemorrhagic shock, after the implantation of a central venoarterial extracorporeal membrane oxygenation.
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