title: [Angina caused by subclavian-coronary steal in patients revascularized with internal mammary artery].
abstract: After coronary bypass surgery in the left internal mammary artery, occlusive atherosclerosis in the proximal subclavian artery can produce reverse flow in the mammary artery and myocardial ischemia (coronary-subclavian steal syndrome). This is a rare cause of recurrent myocardial ischemia. We present two patients with postoperative complete obstruction in the proximal subclavian artery and inverse flow in the mammary artery producing severe ischemia in the left anterior descending artery territory. Both patients were treated with subclavian-subclavian bypass, which in one patient was ineffective in producing an adequate anterograde flow in the left internal mammary artery. We review clinical management, diagnostic methods and therapeutic options used in the coronary-subclavian steal syndrome.
authors.affiliation: Servicio de Cardiología, Hospital Regional Universitario Carlos Haya, Málaga.
authors.forename: J
authors.initials: J
authors.lastname: Alvarez
authors.forename: T
authors.initials: T
authors.lastname: Urda
authors.forename: I
authors.initials: I
authors.lastname: Mancha
authors.forename: J L
authors.initials: JL
authors.lastname: Martínez
authors.forename: J
authors.initials: J
authors.lastname: Gutiérrez
authors.forename: M
authors.initials: M
authors.lastname: Such
authors.forename: R
authors.initials: R
authors.lastname: Vivancos
authors.forename: M
authors.initials: M
authors.lastname: de Mora
authors.forename: J L
authors.initials: JL
authors.lastname: Castillo
authors.forename: N
authors.initials: N
authors.lastname: González de Vega
authors.forename: F
authors.initials: F
authors.lastname: Malpartida
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D013577:Syndrome