title: Reoperative revascularization of an occluded left subclavian artery and left internal mammary artery ostial stenosis.
abstract: An ostial stenosis of the left internal mammary artery graft anastomosed to the left anterior descending artery was responsible for unstable angina in a patient with a previous coronary artery bypass graft. A T-shape arterectomy was performed between the left subclavian artery and left internal mammary artery. Successful revascularization of the lesion was achieved with a carotid-to-subclavian bypass and surgical ostial plasty extending to the proximal left internal mammary graft using a Hemashild a graft. This procedure was performed through a transverse supraclavicular incision to avoid potential hazards of a redo median sternotomy.
authors.affiliation: I.R.C.C.S NEUROMED, Via Atinense N.18, 86077 (ISERNIA), Pozzilli, Italy. edvinprifti@hotmail.com
authors.forename: Edvin
authors.initials: E
authors.lastname: Prifti
authors.forename: Massimo
authors.initials: M
authors.lastname: Bonacchi
authors.forename: Giacomo
authors.initials: G
authors.lastname: Frati
authors.forename: Gabriele
authors.initials: G
authors.lastname: Giunti
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000209:etiology / Q000601:surgery*; D003251:Constriction, Pathologic; D001026:Coronary Artery Bypass / Q000379:methods*; D015150:Echocardiography, Doppler; D005260:Female; D006083:Graft Occlusion, Vascular / Q000601:surgery*; D006801:Humans; D008323:Mammary Arteries / Q000473:pathology / Q000637:transplantation; D012086:Reoperation; D013348:Subclavian Artery; D013349:Subclavian Steal Syndrome / Q000209:etiology / Q000601:surgery