Which measures are used to prevent and treat graft spasm in CABG?

• A. Graft spasm prevention includes calcium channel blockers or nitrates, careful handling of grafts, avoidance of vasoconstrictive stimuli; treatment with vasodilators.
• B. Graft spasm prevention relies on increasing systemic vasoconstriction.
• C. Graft spasm prevention uses beta blockers in all cases.
• D. No specific prevention exists; treat with fluid restriction.

Answer: (C)

Preventing and treating graft spasm in CABG centers on keeping the graft vessels relaxed and minimizing triggers that provoke smooth muscle contraction. Prophylaxis relies on vasodilator strategies such as calcium channel blockers and nitrates, which reduce calcium entry into vascular smooth muscle and promote dilation. Gentle handling of the grafts, careful avoidance of endothelial injury, and limiting vasoconstrictive stimuli (for example, avoiding certain vasopressors and temperature or ischemia-related stress) also help prevent spasm. If spasm occurs, prompt use of vasodilators—including calcium channel blockers, nitrates, and topical or intra-arterial agents like papaverine—relaxes the graft and restores flow. In short, combining pharmacologic prevention with meticulous graft handling and immediate vasodilation during events is the standard approach.