Successful VATS ligation of a large anomalous branch producing IMA steal syndrome after MIDCAB.
The occurrence of a flow "steal phenomenon" from a large branch of the internal mammary artery (IMA) is rare and its pathogenesis is still controversial. We describe a case of a patent large anomalous left IMA branch which produced recurrent angina 3 years post MIDCAB. Transcatheter coil obliteration of the vessel produced symptomatic relief. However, six months later, chest pains recurred in association with unwinding of the coil and recannulization of the collateral vessel. Successful ligation of the culprit branch using a VATS approach is presented.
Pagni
S
S
Department of Surgery, University of Louisville, Kentucky 40202, USA.
Bousamra
M
M
Shirley
M W
MW
Spence
P A
PA
D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000601:surgery*; D003097:Collateral Circulation / Q000502:physiology; D017023:Coronary Angiography; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008323:Mammary Arteries / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D020775:Thoracic Surgery, Video-Assisted