冠状动脉旁路移植术后难治性左乳内动脉痉挛

Vyas Vrinda, Khan Alisha, Singh Avneet

Internal Medicine, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.

Cardiology / Internal Medicine, State University of New York (SUNY) Upstate Medical University, Syracuse, USA.

Cureus. 2020 Feb 19;12(2):e7045. doi: 10.7759/cureus.7045.

Graft spasm is a rare but well-recognized complication of coronary artery bypass grafting (CABG). The occurrence of graft spam is multifactorial and can be fatal if not diagnosed and treated promptly. There are no well-defined guidelines for the management of a severe spasm. We report the case of a 29-year-old man with left internal mammary artery (LIMA) spasm in the immediate post-operative period following CABG. The intracoronary infusion of nitroglycerin relieved the spasm temporarily, confirming the diagnosis. The patient eventually underwent redo bypass grafting.

移植血管痉挛是冠状动脉旁路移植术（CABG）一种罕见但已被充分认识的并发症。移植血管痉挛的发生是多因素的，如果不及时诊断和治疗可能会致命。目前对于严重痉挛的处理尚无明确的指南。我们报告了1例29岁男性患者，在CABG术后即刻发生左乳内动脉（LIMA）痉挛。冠状动脉内输注硝酸甘油暂时缓解了痉挛，从而确诊。该患者最终接受了再次旁路移植术。