Coronary-subclavian steal: a cause of recurrent myocardial ischemia.
Coronary-subclavian steal through an internal mammary artery (IMA) graft is a rare cause of myocardial ischemia in patients who have previously undergone coronary artery bypass surgery. Two patients presented with upper extremity ischemic symptoms and recurrent angina pectoris 3 to 4 years following coronary artery bypass with in situ IMA grafts. Diagnosis of coronary-subclavian steal was confirmed by brachiocephalic arteriography, which showed tight stenosis or occlusion of the proximal subclavian artery. Coronary arteriography showed retrograde filling of the IMA with steal from the coronary circulation. Both patients were successfully treated by carotid-subclavian bypass.
Horowitz
M D
MD
Department of Surgery, University of Miami/Jackson Memorial Medical Center, Fla.
Oh
C J
CJ
Jacobs
J P
JP
Chahine
R A
RA
Livingstone
A S
AS
D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000601:surgery; D001132:Arm / Q000098:blood supply; D001807:Blood Vessel Prosthesis; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007383:Intermittent Claudication / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000601:surgery; D009204:Myocardial Revascularization; D011138:Polytetrafluoroethylene; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000601:surgery; D012086:Reoperation; D013349:Subclavian Steal Syndrome / Q000000981:diagnostic imaging* / Q000601:surgery
D011138:Polytetrafluoroethylene