Relief of vasospasm with fasudil after off-pump coronary artery bypass grafting: a case study
Abstract Background Coronary vasospasm after coronary artery bypass grafting (CABG) is a rare but potentially lethal complication. It is often refractory to several vasodilators. We report a case of refractory coronary vasospasm relieved by fasudil injection. Case presentation A 74-year-old woman wh...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Japan Surgical Society
2018-07-01
|
| Series: | Surgical Case Reports |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s40792-018-0481-9 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849396854245031936 |
|---|---|
| author | Akira Fujita Hiroshi Kurazumi Ryo Suzuki Masaya Takahashi Akihito Mikamo Kimikazu Hamano |
| author_facet | Akira Fujita Hiroshi Kurazumi Ryo Suzuki Masaya Takahashi Akihito Mikamo Kimikazu Hamano |
| author_sort | Akira Fujita |
| collection | DOAJ |
| description | Abstract Background Coronary vasospasm after coronary artery bypass grafting (CABG) is a rare but potentially lethal complication. It is often refractory to several vasodilators. We report a case of refractory coronary vasospasm relieved by fasudil injection. Case presentation A 74-year-old woman who had three instances of in-stent stenosis at the left anterior descending artery (LAD) was referred for CABG treatment. Preoperative coronary angiography showed 90% in-stent stenosis of the proximal LAD and 75% stenosis of the diagonal branch. We performed a left internal thoracic artery (LITA)-LAD bypass and a right internal thoracic artery (RITA) diagonal branch bypass. After anastomosis, transit time flow measurement revealed poor blood flow of LITA-LAD bypass even after re-anastomosis. We performed coronary angiography and detected a vasospasm in the native coronary arteries, which was not relieved using conventional vasodilators (calcium channel blockers, isosorbide dinitrate, and nicorandil) However, we were able to relieve the coronary vasospasm by administering fasudil (a Rho kinase inhibitor) injection without causing systemic hypotension. Conclusions Fasudil may be an important vasodilator, especially in cases of coronary vasospasm after CABG. |
| format | Article |
| id | doaj-art-f5bc6c9bcf2646b1bc7fa894e4791dfe |
| institution | Kabale University |
| issn | 2198-7793 |
| language | English |
| publishDate | 2018-07-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-f5bc6c9bcf2646b1bc7fa894e4791dfe2025-08-20T03:39:13ZengJapan Surgical SocietySurgical Case Reports2198-77932018-07-01411410.1186/s40792-018-0481-9Relief of vasospasm with fasudil after off-pump coronary artery bypass grafting: a case studyAkira Fujita0Hiroshi Kurazumi1Ryo Suzuki2Masaya Takahashi3Akihito Mikamo4Kimikazu Hamano5Department of Surgery and Clinical Science, Graduate School of Medicine, Yamaguchi UniversityDepartment of Surgery and Clinical Science, Graduate School of Medicine, Yamaguchi UniversityDepartment of Surgery and Clinical Science, Graduate School of Medicine, Yamaguchi UniversityDepartment of Surgery and Clinical Science, Graduate School of Medicine, Yamaguchi UniversityDepartment of Surgery and Clinical Science, Graduate School of Medicine, Yamaguchi UniversityDepartment of Surgery and Clinical Science, Graduate School of Medicine, Yamaguchi UniversityAbstract Background Coronary vasospasm after coronary artery bypass grafting (CABG) is a rare but potentially lethal complication. It is often refractory to several vasodilators. We report a case of refractory coronary vasospasm relieved by fasudil injection. Case presentation A 74-year-old woman who had three instances of in-stent stenosis at the left anterior descending artery (LAD) was referred for CABG treatment. Preoperative coronary angiography showed 90% in-stent stenosis of the proximal LAD and 75% stenosis of the diagonal branch. We performed a left internal thoracic artery (LITA)-LAD bypass and a right internal thoracic artery (RITA) diagonal branch bypass. After anastomosis, transit time flow measurement revealed poor blood flow of LITA-LAD bypass even after re-anastomosis. We performed coronary angiography and detected a vasospasm in the native coronary arteries, which was not relieved using conventional vasodilators (calcium channel blockers, isosorbide dinitrate, and nicorandil) However, we were able to relieve the coronary vasospasm by administering fasudil (a Rho kinase inhibitor) injection without causing systemic hypotension. Conclusions Fasudil may be an important vasodilator, especially in cases of coronary vasospasm after CABG.http://link.springer.com/article/10.1186/s40792-018-0481-9Coronary artery vasospasmCoronary artery bypass graftRho kinase inhibitorFasudil |
| spellingShingle | Akira Fujita Hiroshi Kurazumi Ryo Suzuki Masaya Takahashi Akihito Mikamo Kimikazu Hamano Relief of vasospasm with fasudil after off-pump coronary artery bypass grafting: a case study Surgical Case Reports Coronary artery vasospasm Coronary artery bypass graft Rho kinase inhibitor Fasudil |
| title | Relief of vasospasm with fasudil after off-pump coronary artery bypass grafting: a case study |
| title_full | Relief of vasospasm with fasudil after off-pump coronary artery bypass grafting: a case study |
| title_fullStr | Relief of vasospasm with fasudil after off-pump coronary artery bypass grafting: a case study |
| title_full_unstemmed | Relief of vasospasm with fasudil after off-pump coronary artery bypass grafting: a case study |
| title_short | Relief of vasospasm with fasudil after off-pump coronary artery bypass grafting: a case study |
| title_sort | relief of vasospasm with fasudil after off pump coronary artery bypass grafting a case study |
| topic | Coronary artery vasospasm Coronary artery bypass graft Rho kinase inhibitor Fasudil |
| url | http://link.springer.com/article/10.1186/s40792-018-0481-9 |
| work_keys_str_mv | AT akirafujita reliefofvasospasmwithfasudilafteroffpumpcoronaryarterybypassgraftingacasestudy AT hiroshikurazumi reliefofvasospasmwithfasudilafteroffpumpcoronaryarterybypassgraftingacasestudy AT ryosuzuki reliefofvasospasmwithfasudilafteroffpumpcoronaryarterybypassgraftingacasestudy AT masayatakahashi reliefofvasospasmwithfasudilafteroffpumpcoronaryarterybypassgraftingacasestudy AT akihitomikamo reliefofvasospasmwithfasudilafteroffpumpcoronaryarterybypassgraftingacasestudy AT kimikazuhamano reliefofvasospasmwithfasudilafteroffpumpcoronaryarterybypassgraftingacasestudy |