Coronary steal syndrome after coronary artery bypass for anomalous aortic origin of a coronary artery.
Anomalous aortic origin of a coronary artery found in a symptomatic 9-year-old boy was initially treated with coronary artery bypass grafting using a left internal mammary artery anastomoses to the left anterior descending coronary artery, but resulted in coronary ischemia, likely from a steal phenomenon. Subsequent transection of the proximal left internal mammary artery with anastomosis to the ascending aorta, and coronary ostial enlargement, resulted in a durable treatment. We recommend caution in choosing coronary artery bypass grafting using a left internal mammary artery pedicle graft for the treatment of anomalous aortic origin of a coronary artery.
Youdelman
Benjamin A
BA
Division of Cardiothoracic Surgery, Department of Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. benjamin.youdelman@jefferson.edu
Pelletier
Glenn J
GJ
Mesia
C Igor
CI
Jacobs
Marshall L
ML