Perioperative coronary artery spasm after off-pump coronary artery bypass grafting in the non-manipulated coronary artery
Abstract Background Perioperative coronary artery spasm (CAS) following coronary artery bypass grafting (CABG) is a severe or lethal condition that is rarely reported. In addition, rare cases with CAS following CABG in the non-manipulated coronary artery are angiographically documented in the periop...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | https://doi.org/10.1186/s12872-022-02609-6 |
| _version_ | 1828386947015376896 |
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| author | Yunpeng Bai Yiming Bai Nan Jiang Qingliang Chen Zhigang Guo |
| author_facet | Yunpeng Bai Yiming Bai Nan Jiang Qingliang Chen Zhigang Guo |
| author_sort | Yunpeng Bai |
| collection | DOAJ |
| description | Abstract Background Perioperative coronary artery spasm (CAS) following coronary artery bypass grafting (CABG) is a severe or lethal condition that is rarely reported. In addition, rare cases with CAS following CABG in the non-manipulated coronary artery are angiographically documented in the perioperative period. We aimed to report our experiences on the diagnosis and treatment of a case with CAS following off-pump CABG in the non-manipulated coronary artery. Methods A 57-year old male with coronary heart disease and unstable angina willing to undergo CABG was admitted to our department. CABG was recommended as he showed 90% stenosis in distal left anterior descending artery, 90% stenosis in intermediate branch, 90% stenosis in left circumflex coronary artery, as well as 50% stenosis in proximal right coronary artery (RCA). Results After CABG, the patient showed Adams–Stokes syndrome and ST-segment elevation. Then CPR was conducted and coronary angiography indicated perioperative CAS in the non-manipulated posterior descending artery. For the treatment, the patient received nitroglycerin injection into the coronary artery by catheter and pumping of diltiazem. Finally, the patient was discharged on day 7 after surgery. A comprehensive literature search was conducted to summarize the studies focused on the diagnosis and treatment of such condition, which indicated that all of the CAS cases occurred in the manipulated vessels, except one study showing CAS in the untouched native coronary artery which was similar with our case. Conclusions Perioperative CAS in the non-manipulated coronary artery following CABG is a severe or lethal condition that is rarely reported, which deserves close attention by the clinicians in clinical practice. |
| first_indexed | 2024-12-10T05:46:03Z |
| format | Article |
| id | doaj.art-181f1707fcd44e5da6979855c8011a89 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-10T05:46:03Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-181f1707fcd44e5da6979855c8011a892022-12-22T02:00:09ZengBMCBMC Cardiovascular Disorders1471-22612022-04-012211910.1186/s12872-022-02609-6Perioperative coronary artery spasm after off-pump coronary artery bypass grafting in the non-manipulated coronary arteryYunpeng Bai0Yiming Bai1Nan Jiang2Qingliang Chen3Zhigang Guo4Department of Cardiac Surgery, Chest Hospital, Tianjin UniversityDepartment of Cardiac Surgery, Tianjin Chest Hospital, Tianjin Medical UniversityDepartment of Cardiac Surgery, Chest Hospital, Tianjin UniversityDepartment of Cardiac Surgery, Chest Hospital, Tianjin UniversityDepartment of Cardiac Surgery, Chest Hospital, Tianjin UniversityAbstract Background Perioperative coronary artery spasm (CAS) following coronary artery bypass grafting (CABG) is a severe or lethal condition that is rarely reported. In addition, rare cases with CAS following CABG in the non-manipulated coronary artery are angiographically documented in the perioperative period. We aimed to report our experiences on the diagnosis and treatment of a case with CAS following off-pump CABG in the non-manipulated coronary artery. Methods A 57-year old male with coronary heart disease and unstable angina willing to undergo CABG was admitted to our department. CABG was recommended as he showed 90% stenosis in distal left anterior descending artery, 90% stenosis in intermediate branch, 90% stenosis in left circumflex coronary artery, as well as 50% stenosis in proximal right coronary artery (RCA). Results After CABG, the patient showed Adams–Stokes syndrome and ST-segment elevation. Then CPR was conducted and coronary angiography indicated perioperative CAS in the non-manipulated posterior descending artery. For the treatment, the patient received nitroglycerin injection into the coronary artery by catheter and pumping of diltiazem. Finally, the patient was discharged on day 7 after surgery. A comprehensive literature search was conducted to summarize the studies focused on the diagnosis and treatment of such condition, which indicated that all of the CAS cases occurred in the manipulated vessels, except one study showing CAS in the untouched native coronary artery which was similar with our case. Conclusions Perioperative CAS in the non-manipulated coronary artery following CABG is a severe or lethal condition that is rarely reported, which deserves close attention by the clinicians in clinical practice.https://doi.org/10.1186/s12872-022-02609-6Coronary artery spasmCoronary artery bypass graftingAngiographyCalcium channel blocker |
| spellingShingle | Yunpeng Bai Yiming Bai Nan Jiang Qingliang Chen Zhigang Guo Perioperative coronary artery spasm after off-pump coronary artery bypass grafting in the non-manipulated coronary artery BMC Cardiovascular Disorders Coronary artery spasm Coronary artery bypass grafting Angiography Calcium channel blocker |
| title | Perioperative coronary artery spasm after off-pump coronary artery bypass grafting in the non-manipulated coronary artery |
| title_full | Perioperative coronary artery spasm after off-pump coronary artery bypass grafting in the non-manipulated coronary artery |
| title_fullStr | Perioperative coronary artery spasm after off-pump coronary artery bypass grafting in the non-manipulated coronary artery |
| title_full_unstemmed | Perioperative coronary artery spasm after off-pump coronary artery bypass grafting in the non-manipulated coronary artery |
| title_short | Perioperative coronary artery spasm after off-pump coronary artery bypass grafting in the non-manipulated coronary artery |
| title_sort | perioperative coronary artery spasm after off pump coronary artery bypass grafting in the non manipulated coronary artery |
| topic | Coronary artery spasm Coronary artery bypass grafting Angiography Calcium channel blocker |
| url | https://doi.org/10.1186/s12872-022-02609-6 |
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