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Kowalówka AR, Malinowski M, Onyszczuk M, et al. Coronary artery spasm following on-pump coronary artery bypass grafting with 20 months follow-up. Kardiochir Torakochirurgia Pol. 2016;13(4):361-365doi: 10.5114/kitp.2016.64883.
Kowalówka, A. R., Malinowski, M., Onyszczuk, M., & Deja, M. (2016). Coronary artery spasm following on-pump coronary artery bypass grafting with 20 months follow-up. Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery, 13(4), 361-365. https://doi.org/10.5114/kitp.2016.64883
Kowalówka, Adam R, et al. "Coronary artery spasm following on-pump coronary artery bypass grafting with 20 months follow-up." Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery vol. 13,4 (2016): 361-365. doi: https://doi.org/10.5114/kitp.2016.64883
Kowalówka AR, Malinowski M, Onyszczuk M, Deja M. Coronary artery spasm following on-pump coronary artery bypass grafting with 20 months follow-up. Kardiochir Torakochirurgia Pol. 2016 Dec;13(4):361-365. doi: 10.5114/kitp.2016.64883. Epub 2016 Dec 30. PMID: 28096836; PMCID: PMC5233769.
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Kardiochir Torakochirurgia Pol. 2016 Dec;13(4):361-365. doi: 10.5114/kitp.2016.64883. Epub 2016 Dec 30.

Coronary artery spasm following on-pump coronary artery bypass grafting with 20 months follow-up.

Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery

Adam R Kowalówka, Marcin Malinowski, Magdalena Onyszczuk, Marek Deja

Affiliations

  1. Department of Cardiac Surgery, Medical University of Silesia, Katowice, Poland.

PMID: 28096836 PMCID: PMC5233769 DOI: 10.5114/kitp.2016.64883

Abstract

We report on a 69-year-old woman who demonstrated native coronary artery and grafted vessel spasm following on-pump coronary artery bypass grafting (CABG). Despite intraaortic balloon pump (IABP) insertion, electrocardiogram (ECG) abnormalities did not disappear. Emergency coronary angiography (CAG) was performed. The patient was successfully treated with systemic and intracoronary injection of vasodilator agents. ECG changes disappeared, with normalized and stable hemodynamic function. Intraaortic balloon pump was maintained for 48 h. The patient was discharged in good clinical condition. Coronary artery spasm (CAS) may result in life-threatening arrhythmias, circulatory collapse or death. The etiology of CAS is multifactorial and includes heart manipulation, exogenous vasoconstrictors, stress-related catecholamine release, hypoxia and oxidative stress. Postoperative CAS is most commonly manifested by ST-segment elevation and circulatory collapse without specific causes. The gold standard for revealing CAS is CAG. Infusion of vasodilators combined with IABP is adequate in most instances, but extracorporeal membrane oxygenation has been necessary for more extensive or resistant coronary spasm.

Keywords: coronary angiogram; coronary artery bypass grafting; coronary artery spasm; on-pump cardiac surgery

References

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