Refractory Vascular Spasm Associated with Coronary Bypass Grafting

• Published in: Journal of chest surgery pp. 468 - 472
• Main Authors: 김영삼, 윤용한, 김정택, 신혜란, 우성일, 백완기
• Format: Journal Article
• Language: English
• Published: 대한흉부외과학회 01.10.2014
• Subjects: 흉부외과학
• ISSN: 2765-1606; 2765-1614

Diffuse refractory vascular spasms associated with coronary bypass artery grafting (CABG) are rare but devastating. A 42-year-old male patient with a past history of stent insertion was referred for the surgical treatment of a recurrent left main coronary artery disease. A hemodynamic derangement developed during graft harvesting, necessitating a hurried initiation of cardiopulmonary bypass (CPB). Although CABG was carried out as planned, the patient could not be weaned from the bypass. An emergency coronary angiography demonstrated a diffuse spasm of both native coronary arteries and grafts. CPB was switched to the femorofemoral extracorporeal membrane oxygenator (ECMO). Although he managed to recover from heart failure, his discharge was delayed due to the ischemic injury of the lower limb secondary to cannulation for ECMO. We reviewed the case and literature, placing emphasis on the predisposing factors and appropriate management. KCI Citation Count: 0