Successful Management of Unremitting Spasm after Myocardial Revascularization Exclusively with Bilateral Internal Thoracic Arteries in Y-graft Configuration: A Case Report

  • Ovidiu Stiru Department of Cardiovascular Surgery of Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
  • Roxana Carmen Geana Department of Cardiovascular Surgery of Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
  • Diana Ioana Sorostinean Department of Cardiovascular Surgery of Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
  • Marin Postu Department of Cardiovascular Surgery of Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
  • Mihai Stefan Department of Cardiovascular Surgery of Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
  • Ovidiu Chioncel Department of Cardiovascular Surgery of Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
  • Vlad Anton Iliescu Department of Cardiovascular Surgery of Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, Bucharest, Romania
Keywords: coronary artery spasm, coronary artery bypass grafting, total arterial revascularization

Abstract

Coronary artery spasm (CAS) after coronary artery bypass grafting (CABG) is rare, and in time may be fatal for the patient if undiagnosed. The purpose of the present study is to report the case of a patient who survived after experiencing a persistent spasm of all native coronary arteries following successful arterial myocardial revascularization. Furthermore, we aimed to discuss the therapeutic strategies which may prevent the occurrence of a coronary artery spasm in settings of myocardial revascularization, in the context of reviewed specific literature evidences.

References

Buxton AE, Goldberg S, Harken A, Hirshfield J Jr, Kastor JA. 1981. Coronary-artery spasm immediately after myocardial revascularization: recognition and management. N Engl J Med 304:1249-53.

Buxton AE, Hirshfeld Jr JW, Untereker WJ, et al. 1982. Perioperative coronary arterial spasm: long term follow-up. Am J Cardiol 50:444-51.

Gaetano AL, Giulia Careri, Filippo Crea. 2011. Mechanisms of coronary artery spasm. Circulation 124:1774-82.

He GW, Taggart DP. 2016. Antispastic management in arterial grafts in coronary artery bypass grafting surgery. Ann Thorac Surg 102:659-68.

Lemmer JH Jr, Kirsh MM. 1988. Coronary artery spasm following coronary artery surgery. Ann Thorac Surg 46:108-15.

Marques KM, Jensen EE, Huybregts RA. 2006. Profound coronary spasm caused by a mediastinal draining tube. Heart 92:514.

Mayumi H, Kawachi Y, Kohno H, et al. 1994. Drug infusion through a branch of the aortocoronary vein graft for refractory coronary spasm. Ann Thorac Surg 54:869-71.

Pichard AD, Ambrose J, Mindich B, et al. 1980. Coronary artery spasm and perioperative cardiac arrest. J Thorac Cardiovasc Surg 80:249-54.

Schena S, Wildes T, Beardslee MA, Lasala JM, Damiano RJ Jr, Lawton JS. 2007. Successful management of unremitting spasm of the nongrafted right coronary artery after off-pump coronary artery bypass grafting. J Thorac Cardiovasc Surg 133:1649-50.

Teragawa H, Nishioka K, Fujii Y, et al. 2014. Worsening of coronary spasm during the perioperative period: A case report. World J Cardiol 6:685-8.

Published
2019-07-03
How to Cite
Stiru, O., Geana, R., Sorostinean, D., Postu, M., Stefan, M., Chioncel, O., & Iliescu, V. (2019). Successful Management of Unremitting Spasm after Myocardial Revascularization Exclusively with Bilateral Internal Thoracic Arteries in Y-graft Configuration: A Case Report. The Heart Surgery Forum, 22(4), E283-E286. https://doi.org/10.1532/hsf.2040
Section
Articles