Occlusive Coronary-Artery Spasm as a Cause of Acute Myocardial Infarction after Coronary-Artery Bypass Grafting

To the Editor: Acute myocardial infarction occurs in approximately 2 to 6 percent of patients in the immediate postoperative period after coronary-artery bypass grafting.^1,2 The exact cause or causes of perioperative myocardial infarction have not been fully determined. We present angiographic documentation of occlusive spasm of a native coronary artery as a cause of acute myocardial infarction after coronary bypass grafting. A 59-year-old man with a 4-month history of exertional chest pain despite medical therapy was admitted to our institution for coronary-artery bypass grafting. Angiography performed three months before admission demonstrated two-vessel coronary artery disease with total occlusion of the.