Open AccessRefractory Vascular Spasm Associated with Coronary Bypass Grafting
Author(s) -
Young Sam Kim,
Yong Han Yoon,
Jeoung Taek Kim,
Helen Ki Shinn,
Seong Ill Woo,
Wan Ki Baek
Publication year - 2014
Publication title -
the korean journal of thoracic and cardiovascular surgery/daehan hyungbu oe'gwa haghoeji. hyungbu simjang hyeolgwan
Language(s) - Uncategorized
Resource type - Journals
eISSN - 2093-6516
pISSN - 0301-2859
DOI - 10.5090/kjtcs.2014.47.5.468
Subject(s) - medicine , cardiopulmonary bypass , artery , bypass grafting , surgery , refractory (planetary science) , cardiology , membrane oxygenator , anesthesia , physics , astrobiology
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.