[Early coronary spasm after myocardial revascularization surgery].

Six cases of early post-operative coronary artery spasm were observed in a series of 460 consecutive patients who underwent myocardial revascularization. This is a rare accident, only quite recently described. The spasm involves the coronary arterial network or the graft and is reflected in an elevated ST segment accompanied by collapse and ventricular dysrhythmia. The condition may be lethal or may result in myocardial infarction. Treatment consists of calcium inhibitors. The cause of the spasm is unknown, but it seems to be encouraged by trauma of the coronary arteries during surgery and by metabolic changes (production of thromboxane A2) induced by the cardio-pulmonary bypass. This particular spasm must be watched by heart surgeons and their team in order to avoid some deaths and peroperative necroses, as it appears that we are only confronted with its more severe forms.