{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T03:36:23Z","timestamp":1768448183422,"version":"3.49.0"},"reference-count":15,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2007,2,14]],"date-time":"2007-02-14T00:00:00Z","timestamp":1171411200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2007,3]]},"abstract":"<jats:p><jats:bold>Background:\u2003<\/jats:bold> Coronary artery spasm (CAS) in the immediate postoperative period has been recognized as a possible cause for perioperative myocardial ischaemia after off\u2010pump coronary artery bypass grafting (CABG). It varies in severity and can be associated with circulatory collapse and death. The purpose of this study was to present our experiences on CAS after off\u2010pump CABG and detail its management.<\/jats:p><jats:p><jats:bold>Methods:\u2003<\/jats:bold> The case reports of three patients with similar clinical presentations of ischaemic heart disease who underwent CABG using an off\u2010pump technique are reviewed. Severe manifestations of CAS in the immediate postoperative period with documented angiographic findings are presented.<\/jats:p><jats:p><jats:bold>Results:\u2003<\/jats:bold> Three patients (two men and one woman) with angina pectoris were diagnosed with coronary artery disease using coronary angiography. The elective off\u2010pump CABG was uneventful; however, severe manifestation of myocardial ischaemia with abrupt onset developed at the intensive care unit. All three patients underwent immediate coronary angiography to verify the diagnosis of CAS. Apart from intracoronary nitroglycerine infusion and medical support with inotropic agents, extracorporeal membranous oxygenation was carried out because of severe haemodynamic deterioration in one case, while support was required with intraaortic balloon pumping in another. All three patients made a full recovery.<\/jats:p><jats:p><jats:bold>Conclusion:\u2003<\/jats:bold> Coronary artery spasm can severely complicate the postoperative course for patients undergoing off\u2010pump CABG, leading to myocardial ischaemia or infarction, life\u2010threatening arrhythmias, persistent hypotension and even cardiac arrest. Early awareness and diagnosis of CAS with the establishment of appropriate management strategies may prevent its potentially lethal consequences.<\/jats:p>","DOI":"10.1111\/j.1445-2197.2006.03991.x","type":"journal-article","created":{"date-parts":[[2007,2,15]],"date-time":"2007-02-15T07:09:03Z","timestamp":1171523343000},"page":"126-129","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["CORONARY ARTERY SPASM AFTER OFF\u2010PUMP CORONARY ARTERY BYPASS GRAFTING"],"prefix":"10.1111","volume":"77","author":[{"given":"Chih\u2010Yuan","family":"Lin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zen\u2010Chung","family":"Weng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih\u2010Hurng","family":"Loh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gou\u2010Jieng","family":"Hong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chien\u2010Sung","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,2,14]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198105213042101"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198902093200617"},{"key":"e_1_2_7_4_2","first-page":"2667","article-title":"Spasme coronaire precoce apres chirurgie de revascularisation du myocarde","volume":"12","author":"Houppe JP","year":"1983","journal-title":"Presse Med"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/1010-7940(90)90226-P"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(03)00412-3"},{"key":"e_1_2_7_7_2","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/S0022-5223(19)37799-2","article-title":"Coronary artery spasm and perioperative cardiac arrest","volume":"80","author":"Pichard AD","year":"1980","journal-title":"J. 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