The article is dedicated to the management of internal mammary artery spasm intra- and postoperatively based on the accumulated evidence in the literature. It provides a stepwise decision algorithm for safely resolving the spasm and prevention of relapse.
Tector, A.J., Schmahl, T.M. and Canino, V.R. (1983) The Internal Mammary Artery Graft: The Best Choice for Bypass of the Diseased Left Anterior Descending Coronary Artery. Circulation, 68, II214-II217.
Stone, G.W. and Hartzler, G.O. (1989) Spontaneous Reversible Spasm in an Internal Mammary Artery Graft Causing Acute Myocardial Infarction. American Journal of Cardiology, 64, 822-823. http://dx.doi.org/10.1016/0002-9149(89)90777-7
Lorusso, R., Crudeli, E., Lucà, F., De Cicco, G., Vizzardi, E., D’Aloia, A. and Gelsomino, S. (2012) Refractory Spasm of Coronary Arteries and Grafted Conduits after Isolated Coronary Artery Bypass Surgery. Annals of Thoracic Surgery, 93, 545-551. http://dx.doi.org/10.1016/j.athoracsur.2011.09.078
Sarabu, M.R., McClung, J.A., Fass, A. and Reed, G.E. (1987) Early Postoperative Spasm in Left Internal Mammary Artery Bypass Grafts. Annals of Thoracic Surgery, 44, 199-200. http://dx.doi.org/10.1016/S0003-4975(10)62041-3
Kong, B., Kopelman, H., Segal, B.L. and Iskandrian, A.S. (1988) Angiographic Demonstration of Spasm in a Left Internal Mammary Artery Used as a Bypass to the Left Anterior Descending Coronary Artery. American Journal of Cardiology, 61, 1363. http://dx.doi.org/10.1016/0002-9149(88)91191-5
Mills, N.L. and Ochsner, J.L. (1975) Preparations of Internal Mammary Arteries for Coronary Bypass with Intraluminal Papaverine. Journal of Cardiovascular Surgery (Torino), 16, 632-633.
Green, G.E. (1971) Rate of Blood Flow from the Internal Mammary Artery. Surgery, 70, 809-813.
Battaloglu, B., Nisanoglu, V., Erdil, N., Ozgur, B., Eroglu, T., Aydin, N., Kaynak, M. and Secici, S. (2007) Effects of Pretreatment with Different Topical Vasodilators on Blood Flow in the Internal Mammary Artery: A Prospective Randomized Study. Heart Surgery Forum, 10, E136-E140. http://dx.doi.org/10.1532/HSF98.20061166
Sasson, L., Cohen, A.J., Hauptman, E. and Schachner, A. (1995) Effect of Topical Vasodilators on Internal Mammary Arteries. Annals of Thoracic Surgery, 59, 494-496. http://dx.doi.org/10.1016/0003-4975(94)00896-F
Nili, M., Stamler, A., Sulkes, J. and Vidne, B.A. (1999) Preparation of the Internal Thoracic Artery by Vasodilator Drugs: Is It Really Necessary? A Randomized Double-Blind Placebo-Controlled Clinical Study. European Journal Cardio-Thoracic Surgery, 16, 560-563. http://dx.doi.org/10.1016/S1010-7940(99)00308-5
Formica, F., Ferro, O., Brustia, M., Corti, F., Colagrande, L., Bosisio, E. and Paolini, G. (2006) Effects of Papaverine and Glycerylnitrate-Verapamil Solution as Topical and Intraluminal Vasodilators for Internal Thoracic Artery. Annals of Thoracic Surgery, 81, 120-124. http://dx.doi.org/10.1016/j.athoracsur.2005.06.037
Yildiz, O., Ciçek, S., Ay, I., Demirkiliç, U. and Tuncer, M. (1996) Hypertension Increases the Contractions to Sumatriptan in the Human Internal Mammary Artery. Annals of Thoracic Surgery, 62, 1392-1395; Discussion 1396. http://dx.doi.org/10.1016/0003-4975(96)00674-1
Tanaka, N. (2009) Pharmacological Studies on Responsiveness of 5-Hydroxytryptamine in Overcoming Perioperative Spasm of Coronary Artery Bypass Graft. Yakugaku Zasshi, 129, 1049-1053. http://dx.doi.org/10.1248/yakushi.129.1049
Grapow, M.T., Reineke, D.C., Kern, T., Müller-Schweinitzer, E., Carrel, T. and Eckstein, F.S. (2009) Human Internal Thoracic Arteries from Diabetic Patients Are Resistant to Endothelial Dysfunction. Fundamental & Clinical Pharmacology, 23, 567-572. http://dx.doi.org/10.1111/j.1472-8206.2009.00707.x
Turoni, C.M., de Bruno, M.P., Coviello, A., Marañón, R.O., Herrera, R.N., Muntaner, J. and Proto, V. (2007) Internal Mammary Artery Grafts Reactivity in Hypertensive Patients: Role of Stretching in Extraendothelial Nitric Oxide. Clinical and Experimental Hypertension, 29, 327-344. http://dx.doi.org/10.1080/10641960701500570
He, G.W., Fan, K.Y., Chiu, S.W. and Chow, W.H. (2000) Injection of Vasodilators into Arterial Grafts through Cardiac Catheter to Relieve Spasm. Annals of Thoracic Surgery, 69, 625-628. http://dx.doi.org/10.1016/S0003-4975(99)01341-7
Janelle, G.M., Urdaneta, F., Martin, T.D. and Lobato, E.B. (2000) Effects of Calcium Chloride on Grafted Internal Mammary Artery Flow after Cardiopulmonary Bypass. Journal of Cardiothoracic and Vascular Anesthesia, 14, 4-8. http://dx.doi.org/10.1016/S1053-0770(00)90046-6
Cantürk, E., Arslan, C., Altinok, A., &OUMLzyazgan, S., Besirli, K., Bozkurt, A.K. and Akkan, G. (2010) The in vitro Effects of Iloprost with Other Vasodilators on the Human Internal Thoracic Artery. Annals of Thoracic and Cardiovascular Surgery, 16, 78-84.
Akar, F., Manavbasi, Y., Parlar, A.I., Ulus, A.T. and Katircioglu, S.F. (2007) The Gender Differences in the Relaxation to Levosimendan of Human Internal Mammary Artery. Cardiovascular Drugs and Therapy, 21, 331-338. http://dx.doi.org/10.1007/s10557-007-6047-x
Deja, M.A., Golba, K.S., Malinowski, M., Wos, S., Kolowca, M., Biernat, J., Kajor, M. and Spyt, T.J. (2005) Skeletonization of Internal Thoracic Artery Affects Its Innervation and Reactivity. European Journal of Cardio-Thoracic Surgery, 28, 551-557. http://dx.doi.org/10.1016/j.ejcts.2005.06.037
Tanaka, K.A., Szlam, F., Katori, N., Tsuda, A. and Levy, J.H. (2004) In Vitro Effects of Antihypertensive Drugs on Thromboxane Agonist (U46619)-Induced Vasoconstriction in Human Internal Mammary Artery. British Journal of Anaesthesia, 93, 257-262. http://dx.doi.org/10.1093/bja/aeh189
Harskamp, R.E., McNeil, J.D., van Ginkel, M.W., Bastos, R.B., Baisden, C.E. and Calhoon, J.H. (2008) Postoperative Internal Thoracic Artery Spasm after Coronary Artery Bypass Grafting. Annals of Thoracic Surgery, 85, 647-649. http://dx.doi.org/10.1016/j.athoracsur.2007.08.015
Tarhan, A., Kehlibar, T., Yapici, F., Yilmaz, M., Arslan, Y., Yapici, N. and Ozler, A. (2006) Role of Physiological State ‘Normothermia’ in Internal Thoracic Artery Spasm after Harvesting. European Journal Cardio-Thoracic Surgery, 30, 749-752. http://dx.doi.org/10.1016/j.ejcts.2006.09.001
Choi, J.B. and Lee, S.Y. (1996) Skeletonized and Pedicled Internal Thoracic Artery Grafts: Effect on Free Flow during Bypass. Annals of Thoracic Surgery, 61, 909-913. http://dx.doi.org/10.1016/0003-4975(95)01171-4
Massa, G., Johansson, S., Kimblad, P.O., SjÖberg, T. and Steen, S. (1991) Might Free Arterial Grafts Fail Due to Spasm? Annals of Thoracic Surgery, 51, 94-101. http://dx.doi.org/10.1016/0003-4975(91)90458-3
Tabel, Y., Hepaguslar, H., Erdal, C., Catalyürek, H., Acikel, U., Elar, Z. and Aslan, O. (2004) Diltiazem Provides Higher Internal Mammary Artery Flow than Nitroglycerin during Coronary Artery Bypass Grafting Surgery. European Journal Cardio-Thoracic Surgery, 25, 553-559. http://dx.doi.org/10.1016/j.ejcts.2004.01.004
Gaudiani, V.A., Buch, W.S., Chin, A.K., Ayres, L.J. and Fogarty, T.J. (1988) An Improved Technique for the Internal Mammary Artery Coronary Bypass Graft Procedure. Journal of Cardiac Surgery, 3, 467-473. http://dx.doi.org/10.1111/j.1540-8191.1988.tb00439.x
Jeanmart, H., Perrault, L.P., Desjardins, N., Chavanon, O., Carrier, M. and Fonger, J.D. (2001) Arterial Balloon Catheter: A New Atraumatic Device for Dilating Arterial Grafts. Annals of Thoracic Surgery, 72, 810-815, Discussion 816. http://dx.doi.org/10.1016/S0003-4975(01)02895-8
Abad, C., Valerón, M.E., Cáceres, J.J. and Avalos, O. (2001) Preparation of the Internal Mammary Artery with the IMAG Fogarty Balloon Catheter. Minerva cardioangiologica, 49, 263-266.
Minami, T., Suzuki, S., Isomatsu, Y., Kasama, K., Matsuki, Y. and Masuda, M. (2010) Usefulness of Photo Dynamic Eye System for Detection of Graft Spasm in Off-Pump Coronary Artery Bypass Grafting. Kyobu Geka, 63, 809-812.
Bertona, R., De Candia, G., Boccuzzi, G., Ribichini, F., Agostini, M. and Vassanelli, C. (2004) Left Internal Mammary Artery Graft Stenosis. Atherosclerosis, Spasm or Kinking? Italian Heart Journal. Supplement, 5, 53-58.
Fakiolas, C.N., Adamopoulou, E.N., Kouvaras, G.A., Olympios, C.D. and Foussas, S.G. (1995) Systolic Segmental Disappearance of Internal Mammary Artery Graft. Correlation with Prolonged Spasm of the Graft. Acta Cardiologica, 50, 71-77.
Sanders, L.H. and Newman, M.A. (2005) Intractable Postoperative Internal Thoracic Artery Spasm Managed with Angiographic Intraluminal Papaverine. Journal of Thoracic and Cardiovascular Surgery, 130, 938-940. http://dx.doi.org/10.1016/j.jtcvs.2005.04.022
Kitamura, H., Nakayama, K. and Kitano, T. (2001) A Case of Refractory Spasm of Multiple Coronary Arteries and Left Internal Thoracic Artery Graft Following Off-Pump CABG. Kyobu Geka, 54, 1103-1106.
Kollar, A., Simonton, C.A., Thomley, A.M. and Selle, J.G. (1996) Balloon Angioplasty of the Internal Mammary Artery Trunk for Early Postoperative Ischemia: A Case Report. Catheterization and Cardiovascular Diagnosis, 37, 49-51. http://dx.doi.org/10.1002/(SICI)1097-0304(199601)37:1 3.0.CO;2-R
Pratt, G.F., Erickson, M., Provenzano, S., Mews, G. and Edwards, M. (2008) Intractable LIMA Spasm in the Postoperative Period Treated by Placement of ‘Bridging’ Stent. Annals of Thoracic Surgery, 86, 1985-1987. http://dx.doi.org/10.1016/j.athoracsur.2008.05.035
Vogt, P.R., Hess, O. and Turina, M.I. (1996) Internal Mammary Artery Spasm Immediately after Grafting to the Left Anterior Descending Artery: Diagnosis and Treatment. European Heart Journal, 17, 804. http://dx.doi.org/10.1093/oxfordjournals.eurheartj.a014950
Arnaudov, D., Cohen, A.J., Zabeeda, D., Hauptman, E., Sasson, L., Schachner, A. and Ezra, S. (1996) Effect of Systemic Vasodilators on Internal Mammary Flow during Coronary Bypass Grafting. Annals of Thoracic Surgery, 62, 1816-1819. http://dx.doi.org/10.1016/S0003-4975(96)00741-2
Polvani, G., Marino, M.R., Roberto, M., Dainese, L., Parolari, A., Pompilio, G., Di Matteo, S., Fumero, A., Cannata, A., Barili, F. and Biglioli, P. (2002) Acute Effects of 17β-Estradiol on Left Internal Mammary Graft after Coronary Artery Bypass Grafting. Annals of Thoracic Surgery, 74, 695-699. http://dx.doi.org/10.1016/S0003-4975(02)03742-6
Kelsall, C.J., Chester, A.H., Amrani, M. and Singer, D.R. (2005) C-Type Natriuretic Peptide Relaxes Human Coronary Artery Bypass Grafts Preconstricted by Endothelin-1. Annals of Thoracic Surgery, 80, 1347-1351. http://dx.doi.org/10.1016/j.athoracsur.2005.01.069
Buzun, L., Kleszczewski, T., Kostrzewska, A., Lisowski, P., Oleksza, P., Jackowski, R., Pedzińska, A. and Hirnle, T. (2004) Influence of Low Molecular Weight Heparin Preparations on Human Internal Thoracic Artery Contraction. European Journal of Cardio-Thoracic Surgery, 26, 951-955.
Coskun, B., Soylemez, S., Parlar, A.I., Tulga Ulus, A., Fehmi Katircioglu, S. and Akar, F. (2006) Effect of Resveratrol on Nitrate Tolerance in Isolated Human Internal Mammary Artery. Journal of Cardiovascular Pharmacology, 47, 437-445.
Ege, T., Gur, O., Karadag, C.H. and Duran, E. (2010) Evaluation of Iloprost to Prevent Vasospasm in Coronary Artery Bypass Grafts. Journal of International Medical Research, 38, 1759-1763. http://dx.doi.org/10.1177/147323001003800521
Watanabe, G., Noda, Y., Takagi, T., Tomita, S., Yamaguchi, S. and Kiuchi, R. (2013) Fasudil Is a Superior Vasodilator for the Internal Thoracic Artery in Coronary Surgery. Annals of Thoracic Surgery, 96, 543-547. http://dx.doi.org/10.1016/j.athoracsur.2013.04.039
Cracowski, J.L., Chavanon, O., Durand, M., Borrel, E., Devillier, P., Mallion, J.M. and Blin, D. (1997) Effect of Low-Dose Positive Inotropic Drugs on Human Internal Mammary Artery Flow. Annals of Thoracic Surgery, 64, 1742-1746. http://dx.doi.org/10.1016/S0003-4975(97)01103-X
Usta, C., Eksert, B., GÖlbasi, I., Bigat, Z. and Ozdem, S.S. (2006) The Role of Potassium Channels in the Vasodilatory Effect of Levosimendan in Human Internal Thoracic Arteries. European Journal of Cardio-Thoracic Surgery, 30, 329-332. http://dx.doi.org/10.1016/j.ejcts.2006.05.019
Akar, F., Manavbasi, Y., Parlar, A.I., Ulus, A.T. and Katircioglu, S.F. (2007) The Gender Differences in the Relaxation to Levosimendan of Human Internal Mammary Artery. Cardiovascular Drugs and Therapy, 21, 331-338. http://dx.doi.org/10.1007/s10557-007-6047-x
Mirkhani, H., Shafa, M. and Khazraei, H. (2009) Comparison of the Effects of Levosimendan and Papaverine on Human Internal Mammary Artery and Saphenous Vein. Cardiovascular Drugs and Therapy, 23, 355-359. http://dx.doi.org/10.1007/s10557-009-6197-0
Liu, J.J., Doolan, L.A., Xie, B., Chen, J.R. and Buxton, B.F. (1997) Direct Vasodilator Effect of Milrinone, an Inotropic Drug, on Arterial Coronary Bypass Grafts. FANZCA. Journal of Thoracic and Cardiovascular Surgery, 113, 108-113. http://dx.doi.org/10.1016/S0022-5223(97)70405-7
Lobato, E.B., Janelle, G.M., Urdaneta, F. and Martin, T.D. (2001) Comparison of Milrinone versus Nitroglycerin, Alone and in Combination, on Grafted Internal Mammary Artery Flow after Cardiopulmonary Bypass: Effects of αAdrenergic Stimulation. Journal of Cardiothoracic and Vascular Anesthesia, 15, 723-727. http://dx.doi.org/10.1053/jcan.2001.28316
Mollhoff, T., Schmidt, C., Van Aken, H., et al. (2002) Myocardial Ischaemia in Patients with Impaired Left Ventricular Function Undergoing Coronary Artery Bypass Grafting-Milrinone versus Nifedipine. European Journal of Anaesthesiology, 19, 796-802.
Irat, A.M., Aslamaci, S., Karasu, C. and Ari, N. (2006) Alteration of Vascular Reactivity in Diabetic Human Mammary Artery and the Effects of Thiazolidinediones. Journal of Pharmacy and Pharmacology, 58, 1647-1653. http://dx.doi.org/10.1211/jpp.58.12.0012