Massive coronary spasm of the native coronary system after coronary artery bypass grafting: Two patients with different outcomes

J Card Surg. 2020 Aug;35(8):2106-2109. doi: 10.1111/jocs.14849. Epub 2020 Jul 11.

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.

Keywords: coronary artery bypass grafting; coronary artery spasm.

Publication types

  • Case Reports

MeSH terms

  • Coronary Angiography
  • Coronary Artery Bypass / adverse effects*
  • Coronary Artery Disease / surgery*
  • Coronary Vasospasm / diagnostic imaging
  • Coronary Vasospasm / etiology*
  • Coronary Vasospasm / physiopathology
  • Coronary Vasospasm / therapy*
  • Fatal Outcome
  • Female
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / diagnostic imaging
  • Postoperative Complications / etiology*
  • Postoperative Complications / physiopathology
  • Postoperative Complications / therapy*
  • Severity of Illness Index
  • Shock, Cardiogenic / etiology*
  • Treatment Outcome