Coronary artery spasm of the native right coronary artery during off-pump coronary surgery of the left coronary artery system.
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.
Bossert
Torsten
T
Department of Cardiac Surgery, Heart Center, University of Leipzig, Strümpellstr. 39, 04289 Leipzig, Germany. TBossert11@aol.com
Bittner
Hartmuth Bruno
HB
Gummert
Jan Fritz
JF
Mohr
Friedrich Wilhelm
FW
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
D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form