title: Coronary artery spasm of the native right coronary artery during off-pump coronary surgery of the left coronary artery system.
abstract: Native coronary artery spasm is a very rare complication during off-pump coronary artery bypass grafting. We report the case of a 74-year-old man who experienced angiographically documentated right coronary artery spasm while undergoing off-pump coronary artery bypass grafting on the diseased left coronary system. Despite two episodes of ventricular fibrillation and persistent ST segment elevation of the posterior wall, the off-pump procedure was successfully completed by grafting the left internal thoracic artery to the left anterior descending artery and a saphenous vein graft to the Ramus intermedius. The immediate postoperatively performed coronary angiography demonstrated patent anastomoses and two areas of significant spasticity within the course of the right coronary artery. Intracoronary nitroglycerin infusion into the ostium of the right coronary artery resolved the spasms of this nondiseased vessel as well as the associated ST segment elevations.
authors.affiliation: Department of Cardiac Surgery, Heart Center, University of Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany. TBossert11@aol.com
authors.forename: Torsten
authors.initials: T
authors.lastname: Bossert
authors.forename: Hartmuth Bruno
authors.initials: HB
authors.lastname: Bittner
authors.forename: Jan Fritz
authors.initials: JF
authors.lastname: Gummert
authors.forename: Friedrich Wilhelm
authors.initials: FW
authors.lastname: Mohr
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D047549:Coronary Artery Bypass, Off-Pump / Q000379:methods*; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging / Q000209:etiology*; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form / Q000097:blood; D006801:Humans; D008297:Male
chemical_list: D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form