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Case Reports
. 2022 Sep 9:2022:9003921.
doi: 10.1155/2022/9003921. eCollection 2022.

Successful Treatment of Whole Coronary Artery Spasm after Off-Pump Coronary Artery Bypass Grafting

Akihiro Kobayashi  1 , Yoshimori Araki  1 , Takafumi Terada  1 , Osamu Kawaguchi  1
Affiliations
Case Reports

Successful Treatment of Whole Coronary Artery Spasm after Off-Pump Coronary Artery Bypass Grafting

Akihiro Kobayashi et al. Case Rep Cardiol. .

Abstract

Coronary artery spasm after coronary artery bypass grafting is a rare but life-threatening condition. Herein, we report the case of a 77-year-old man who received off-pump coronary artery bypass grafting. An hour after surgery, there was a sudden hemodynamic compromise due to coronary artery spasm, prompting emergent coronary angiography with extracorporeal membrane oxygenation support. Because the angiography results showed diffuse severe spasm of the entire native coronary artery, the patient was treated with an intracoronary injection of vasodilators. The patient recovered in 7 days with mechanical support, catecholamines, and vasodilators, and he was discharged on postoperative day 30. Although coronary artery spasm after off-pump coronary artery bypass surgery is a rare condition, it must be suspected when sudden circulatory collapse occurs.

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Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this article.

Figures

Figure 1
Figure 1
Coronary angiography showed a 75% stenosis of the left main coronary artery, 99% stenosis of the left ascending artery, 90% stenosis of the right coronary artery, and 75% stenosis of the atrioventricular branch.
Figure 2
Figure 2
Emergent coronary angiography. Diffuse severe spasm of whole native coronary arteries (a). The internal mammary artery and great saphenous vein were patent (b).
Figure 3
Figure 3
Coronary spasm was still partially present, but flow gradually improved.
See this image and copyright information in PMC

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