Key result
IABP, high-dose catecholamines, and vasodilators rescue refractory post-OPCAB lethal coronary spasm.
Why the study?
Coronary artery spasm after coronary artery bypass grafting is a rare cause of acute myocardial infarction and its management can be challenging.
Case Report (n=1)
No
Intra-aortic balloon pumping combined with high-dose catecholamines can successfully manage refractory lethal coronary spasm following off-pump CABG when intracoronary vasodilators fail.
Answers are grounded in this paper and cite their sources.
May inform rescue strategies for refractory post-CABG spasm; leaves open need for prospective validation before broader adoption.
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.
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Hosoba et al. (2011) conducted a case report in Refractory lethal coronary spasm after off-pump coronary bypass grafting (n=1). Intra-aortic balloon pumping (IABP), high-dose catecholamines, and vasodilators was evaluated on Recovery of cardiac function and survival. A 68-year-old man with refractory lethal coronary spasm after off-pump coronary bypass grafting was successfully managed with intra-aortic balloon pumping, high-dose catecholamines, and vasodilators.
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