naa a22 4500 510728073 CHVBK 20180411082942.0 cr unu---uuuuu 180411e20131201xx s 000 0 eng 10.1007/s11748-012-0201-5 doi (NATIONALLICENCE)springer-10.1007/s11748-012-0201-5 Prompt institution of percutaneous cardiopulmonary support managed perioperative refractory vascular spasm after isolated coronary artery bypass grafting surgery [Elektronische Daten] [Harumasa Nakazawa, Kiyoshi Moriyama, Akira Motoyasu, Hidehito Endo, Hiroshi Kubota, Tomoko Yorozu] A 51-year-old Japanese male underwent on-pump coronary artery bypass grafting surgery. After weaning from cardiopulmonary bypass (348min), sudden bradycardia and hypotension occurred, followed by ventricular fibrillation. Although defibrillation and infusion of catecholamine restored sinus rhythm, transesophageal echocardiography demonstrated severely reduced contraction of both ventricles, and perioperative vascular spasm was suspected. As vascular spasm was refractory to medications, percutaneous cardiopulmonary support (PCPS) system was quickly instituted under cardiac massage. Coronary angiography revealed vascular spasm of not only the native coronary arteries but also the implanted left internal thoracic artery. After 3days of full hemodynamic assist, PCPS was withdrawn with no obvious abnormalities in regional wall motion by transesophageal echocardiography. The patient was extubated on postoperative day 6 with no impaired brain function. In this case, the immediate diagnosis of refractory vascular spasm by transesophageal echocardiography and full cardiocirculatory assistance by PCPS helped to save the life of the patient. The Japanese Association for Thoracic Surgery, 2013 Transesophageal echocardiography nationallicence Percutaneous cardiopulmonary support nationallicence Perioperative refractory vascular spasm nationallicence Nakazawa Harumasa Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, 181-8611, Mitaka, Tokyo, Japan aut Moriyama Kiyoshi Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, 181-8611, Mitaka, Tokyo, Japan aut Motoyasu Akira Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, 181-8611, Mitaka, Tokyo, Japan aut Endo Hidehito Department of Cardiovascular Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, 181-8611, Mitaka, Tokyo, Japan aut Kubota Hiroshi Department of Cardiovascular Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, 181-8611, Mitaka, Tokyo, Japan aut Yorozu Tomoko Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, 181-8611, Mitaka, Tokyo, Japan aut General Thoracic and Cardiovascular Surgery Springer Japan 61/12(2013-12-01), 711-715 1863-6705 61:12<711 2013 61 11748 https://doi.org/10.1007/s11748-012-0201-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11748-012-0201-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nakazawa Harumasa Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, 181-8611, Mitaka, Tokyo, Japan aut NATIONALLICENCE 700 1- Moriyama Kiyoshi Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, 181-8611, Mitaka, Tokyo, Japan aut NATIONALLICENCE 700 1- Motoyasu Akira Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, 181-8611, Mitaka, Tokyo, Japan aut NATIONALLICENCE 700 1- Endo Hidehito Department of Cardiovascular Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, 181-8611, Mitaka, Tokyo, Japan aut NATIONALLICENCE 700 1- Kubota Hiroshi Department of Cardiovascular Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, 181-8611, Mitaka, Tokyo, Japan aut NATIONALLICENCE 700 1- Yorozu Tomoko Department of Anesthesiology, Kyorin University School of Medicine, 6-20-2 Shinkawa, 181-8611, Mitaka, Tokyo, Japan aut NATIONALLICENCE 773 0- General Thoracic and Cardiovascular Surgery Springer Japan 61/12(2013-12-01), 711-715 1863-6705 61:12<711 2013 61 11748 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer