Coronary-subclavian steal: correction of recurrent angina and cerebrovascular symptoms.
Six months following aortic valve replacement and myocardial revascularization using the left internal mammary artery as a pedicle graft, recurrent angina and cerebrovascular symptoms occurred in our patient. Cardiac catheterization demonstrated a subtotal stenosis of the proximal left subclavian artery and a patent internal mammary artery graft with angiographic steal from the myocardium. The angina and cerebrovascular symptoms were relieved with correction of the proximal subclavian stenosis by balloon angioplasty. This demonstrates the importance of aortic arch and subclavian evaluation and selected angiography prior to myocardial revascularization using the internal mammary artery as a pedicle graft.
George
S M
SM
Department of Surgery, Baylor College of Medicine, Houston, Texas.
Noon
G P
GP
Hausknecht
M J
MJ
D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis* / Q000628:therapy; D000800:Angioplasty, Balloon; D001021:Aortic Valve; D006328:Cardiac Catheterization; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000628:therapy; D002933:Cineradiography; D003327:Coronary Disease / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D011183:Postoperative Complications / Q000175:diagnosis* / Q000628:therapy; D012008:Recurrence; D013349:Subclavian Steal Syndrome / Q000175:diagnosis* / Q000628:therapy