Reoperative revascularization of an occluded left subclavian artery and left internal mammary artery ostial stenosis.
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.
Prifti
Edvin
E
I.R.C.C.S NEUROMED, Via Atinense N.18, 86077 (ISERNIA), Pozzilli, Italy. edvinprifti@hotmail.com
Bonacchi
Massimo
M
Frati
Giacomo
G
Giunti
Gabriele
G
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