Diffuse Coronary Vasospasm After Zone 2 Debranching and Antegrade TEVAR

Coronary vasospasm involves constriction of the coronary arteries and has been described after manipulation of the coronary arteries (ie, after stenting or bypass grafting). This report details the case of a 57-year-old man who presented with an endoleak after thoracic endovascular aortic repair. He underwent a frozen elephant trunk procedure and postoperatively had diffuse coronary vasospasm, demonstrated on pre- and post-vasospasm cardiac catheterization. He required venoarterial extracorporeal membrane oxygenation for hemodynamic support and experienced complete recovery of cardiac function over the subsequent week. This case highlights the rarity of diffuse coronary vasospasm, documents its possibility after aortic surgery, and characterizes its successful treatment.