A 46 year old man presented with an acute coronary syndrome in October 2003. Coronary angiography revealed severe triple vessel disease and urgent bypass grafting was performed, joining the left internal mammary artery (LIMA) to the left anterior descending artery (LAD). During two attempts to close the thorax, episodes of severe hypotension occurred. These were considered by the surgeons to be associated with the LIMA (vasospasm). Therefore they decided to …