Relief of vasospasm with fasudil after off-pump coronary artery bypass grafting: a case study

Bibliographic Details
Title: Relief of vasospasm with fasudil after off-pump coronary artery bypass grafting: a case study
Authors: Akira Fujita, Hiroshi Kurazumi, Ryo Suzuki, Masaya Takahashi, Akihito Mikamo, Kimikazu Hamano
Source: Surgical Case Reports, Vol 4, Iss 1, Pp 1-4 (2018)
Publisher Information: SpringerOpen, 2018.
Publication Year: 2018
Collection: LCC:Surgery
Subject Terms: Coronary artery vasospasm, Coronary artery bypass graft, Rho kinase inhibitor, Fasudil, Surgery, RD1-811
More Details: 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.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2198-7793
Relation: http://link.springer.com/article/10.1186/s40792-018-0481-9; https://doaj.org/toc/2198-7793
DOI: 10.1186/s40792-018-0481-9
Access URL: https://doaj.org/article/f5bc6c9bcf2646b1bc7fa894e4791dfe
Accession Number: edsdoj.f5bc6c9bcf2646b1bc7fa894e4791dfe
Database: Directory of Open Access Journals
More Details
ISSN:21987793
DOI:10.1186/s40792-018-0481-9
Published in:Surgical Case Reports
Language:English