TY - JOUR
AU - Chiu, Shui-Wah
AB - IMAGES IN CARDIOTHORACIC MEDICINE AND SURGERY Coronary Artery Spasm of a Non-Culprit Vessel During Off-Pump Bypass Surgery On-Hng Kwok, FACC, Wing-Hing Chow, FRCP, Shui-Wah Chiu, FRCS Division of Cardiology University Department of Medicine Division of Cardiothoracic Surgery University Department of Surgery Grantham Hospital, Hong Kong. Figure 1. Preoperative “normal” coronary angiogram Figure 2. Multiple sites of coronary spasm involving the right ventricular branch. A 53-year-old man, with a history of single left anterior descending artery (LAD) disease and repeated percutaneous coronary interventions, was referred for off-pump bypass surgery. Right coronary artery (RCA) was normal on preoperative angiogram (Figure 1). Direct off-pump revascularization of the LAD with a saphenous vein graft was successful. However, the cardiac monitor revealed pronounced intermittent ST elevation over the inferior leads intraoperatively. Blood pressure was labile. Emergent coronary angiogram showed patent graft and multiple sites of severe coronary artery spasm over the RCA, involving the right ventricular branch (Figure 2). Boluses of intracoronary nitroglycerin, adenosine, verapamil and sodium nitroprusside were administered meticulously. The spasm was relieved and blood pressure increased (Figure 3). ST-elevation was resolved. Continuous intravenous infusion of nitroglycerin and diltiazem was started. Patient recovery was uneventful. Figure 3. Coronary spasm relieved by intracoronary 
TI - Coronary Artery Spasm of a Non-Culprit Vessel during Off-Pump Bypass Surgery
JF - Asian Cardiovascular and Thoracic Annals
DO - 10.1177/021849230401200125
DA - 2004-03-01
UR - https://www.deepdyve.com/lp/sage/coronary-artery-spasm-of-a-non-culprit-vessel-during-off-pump-bypass-cmjZN30Zx9
SP - 91
EP - 91
VL - 12
IS - 1
DP - DeepDyve
ER -