冠状動脈バイパス術後に重症冠状動脈攣縮をきたした1例

Severe Coronary Artery Spasm after Coronary Artery Bypass Grafting；Report of a Case

はじめに　冠状動脈バイパス術（CABG）の術中・術後は，血行動態が不安定であるため，いったん冠攣縮が発症すると致死的になる可能性がある．われわれは当科において，CABG後に重症冠攣縮をきたした1例を経験したので報告する．

Coronary artery spasm after coronary artery bypass grafting （CABG） is rare and often fatal. There is no established treatment for perioperative coronary spasm because of the rare and not fully understood complications. We report a 67-year-old male, who experienced perioperative spasm of native coronary arteries and the left thoracic artery graft following CABG. Several transcatheter intracoronary injections of isosorbide sulfate failed to relieve the spasm completely. After 5 days’ circulatory support with intra-aortic balloon pumping, the cardiac function improved and the patient recovered. Echocardiography performed before discharge showed decreased left ventricular systolic function with apical akinesis. Postoperative coronary angiography revealed 4 of the 5 grafts were patent.