Espasmo coronariano no pós-operatório de cirurgia de revacularização do miocárdio sem circulação extracorpórea: Diagnóstico e manejo

Abstract

Coronary artery spasm in perioperative of coronary artery bypass graft surgery is a serious complication, with high rate mortality. Patient 51 years-old submitted to coronary artery bypass graft surgery without Extracorporeal Circulation. The patient evolved in 1st post operative (PO) day with enzymatic alteration and ST-elevation, developing soon afterwards in ventricular fibrillation, defibrillation with success. Cardiac catheterization showed important spasm of all coronary arteries and anastomosis between the left internal thoracic artery and the left anterior interventricular artery. Intracoronary Vasodilators and intra-graft, with re-establishment of their usual and immediate calibers to improve clinic and Hemodynamic stability was used. Satisfactory evolution, discharged at 13rd PO day.

RhoA/rho-kinase, nitric oxide and inflammatory response in LIMA during OPCABG with isoflurane preconditioning

“…Reports [1, 2] have showed that autologous arteries rather than veins as bypass graft provide superior long-term outcomes. Moreover, using of LIMA to graft the diseased left anterior descending coronary artery has become the standard method for almost all CABG surgery [3]. However, graft spasm, especially in LIMA with an incidence of at least 0.43% in all CABG surgery [4], and graft stenosis still cause the problem in patients undergoing CABG surgery.…”