title: Successful management of refractory lethal coronary spasm after off-pump coronary bypass grafting.
abstract: Coronary artery spasm after coronary artery bypass grafting is a rare cause of acute myocardial infarction. A 68-year-old man who successfully tolerated off-pump coronary artery bypass grafting had a life-threatening spasm at 16 hours postoperatively. Emergent coronary angiography was performed and demonstrated whole vessel spasm of the bilateral coronary arteries and completely patent grafts. Several transcatheter intracoronary injections of vasodilators failed to relieve the spasm completely. After observation in ICU for 4 days with intra-aortic balloon pumping and a high dose of catecholamine, cardiac function was re-established and the patient recovered.
authors.affiliation: Division of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan. sohosoba@belle.shiga-med.ac.jp
authors.forename: Soh
authors.initials: S
authors.lastname: Hosoba
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Suzuki
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Takashima
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuryanagi
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Nota
authors.forename: Tohru
authors.initials: T
authors.lastname: Asai
mesh_terms: D000368:Aged; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D002395:Catecholamines / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D003422:Critical Care; D004351:Drug Resistance; D006801:Humans; D007269:Injections, Intra-Arterial; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D020127:Recovery of Function; D013997:Time Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*
chemical_list: D002316:Cardiotonic Agents; D002395:Catecholamines; D014665:Vasodilator Agents