Coronary artery steal syndrome in patient after coronary arteries by-pass surgery and left subclavian artery stenting-is the maintenance of a patent internal mammary artery still necessary?

2016 ◽  
Vol 8 (5) ◽  
Author(s):  
Rafal Januszek ◽  
Artur Dziewierz ◽  
Andrzej Brzychczy ◽  
Marcin Misztal ◽  
Dariusz Dudek
Keyword(s):  
Coronary Artery ◽  
Subclavian Artery ◽  
Coronary Arteries ◽  
Internal Mammary Artery ◽  
Left Subclavian Artery ◽  
Internal Mammary ◽  
Steal Syndrome

scholarly journals Treatment of an Unusual Occurrence of a Complex Left Subclavian Artery/Left Internal Mammary Artery Bifurcation Stenosis in the Setting of Coronary Subclavian Steal Syndrome and Ischemic Left Ventricular Systolic Dysfunction

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Michael J. Martinelli ◽  
Michael B. Martinelli
Keyword(s):  
Subclavian Artery ◽  
Internal Mammary Artery ◽  
Left Subclavian Artery ◽  
Left Internal Mammary Artery ◽  
Systolic Dysfunction ◽  
Left Ventricular ◽  
Subclavian Steal Syndrome ◽  
Internal Mammary ◽  
Coronary Subclavian Steal Syndrome ◽  
Steal Syndrome

This case will illustrate the clinical and unique technical challenges, not previously reported, in a patient with a history of progressive left ventricular (LV) systolic dysfunction, congestive heart failure (CHF), myocardial infarction (MI), and a complex bifurcation lesion of the left subclavian artery (SA) involving the left internal mammary artery (LIMA) in the setting of coronary subclavian steal syndrome (CSSS). The approach to this lesion is complicated by significant LIMA involvement requiring intervention directed toward both the SA and the LIMA in the presence of severe LV systolic dysfunction. This clinical scenario necessitates a careful technique, utilizing bifurcation methods similar to those used in coronary intervention.

scholarly journals Stenting for Left Subclavian Artery Stenosis before and after Coronary Artery Bypass Grafting Using the Internal Mammary Artery

2008 ◽  
Vol 14 (2) ◽  
pp. 209-214 ◽  
Author(s):  
I. Chokyu ◽  
T. Terada ◽  
Y. Matsuda ◽  
H. Okumura ◽  
A. Shintani ◽  
...  
Keyword(s):  
Subclavian Artery ◽  
Internal Mammary Artery ◽  
Artery Bypass ◽  
Artery Stenosis ◽  
Cardiac Ischemia ◽  
Subclavian Artery Stenosis ◽  
The Third ◽  
Before And After ◽  
Internal Mammary ◽  
Steal Syndrome

Stenosis of the subclavian artery proximal to the origin of the internal mammary artery (IMA) used for coronary artery bypass grafting may produce flow reversal (steal syndrome) and cause myocardial ischemia. We present three cases of subclavian artery stenosis proximal to the IMA before and after CABG. The first case developed symptomatic myocardial ischemia resulting from a variant of coronary-subclavian steal syndrome. The second case had asymptomatic subclavian artery stenosis proximal to the IMA used for CABG. In the third case we planned to perform CABG using the left IMA to treat cardiac ischemia. All of the patients were successfully treated by stent placement without the use of a protection device. In the first and second cases, cardiac ischemia did not appear during balloon inflation of the subclavian artery and no embolic complication occurred. In the third case, CABG was performed six months after stenting. Subclavian artery stenting is a valid alternative to surgical treatment to restore the flow to the IMA before or after CABG.

Coronary Subclavian Steal Syndrome: A Contemporary Review

Cardiology ◽  
2020 ◽  
Vol 145 (9) ◽  
pp. 601-607
Author(s):  
Hassan M. Lak ◽  
Rohan Shah ◽  
Beni Rai Verma ◽  
Eric Roselli ◽  
Francis Caputo ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Subclavian Artery ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Subclavian Steal Syndrome ◽  
Subclavian Steal ◽  
Internal Mammary ◽  
Coronary Subclavian Steal Syndrome ◽  
The Cost ◽  
Steal Syndrome

Coronary subclavian steal syndrome (CSSS) is a rare cause of angina. It occurs in patients with prior coronary artery bypass grafting and, specifically, a left internal mammary artery (LIMA) to left anterior descending artery (LAD) graft and co-existent significant subclavian artery stenosis. In this context, there is retrograde blood flow through the LIMA to LAD graft to supply the subclavian artery beyond the significant stenosis. This potentially occurs at the cost of compromising coronary artery perfusion dependent on the LIMA graft. In this review, we present a case of a middle-aged female who suffered from CSSS and review the literature for the contemporary diagnosis and management of this condition.

scholarly journals Occluded mammary graft post-coronary bypass surgery: do we need to look for the second one? A case report

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Sergey Yalonetsky ◽  
Ariel Roguin ◽  
Gil Gross ◽  
Rafael Beyar
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass ◽  
Subclavian Artery ◽  
Left Subclavian Artery ◽  
Artery Bypass ◽  
Arterial Graft ◽  
Anatomical Variant ◽  
Anatomic Variant ◽  
Retrograde Filling ◽  
Internal Mammary

Abstract Background Anatomic variations of the left internal mammary artery (LIMA) can influence coronary artery bypass surgical technique as well as posing definite difficulties in the interpretation of angiographic findings. We present an unusual anatomic variant of two LIMAs originating from the left subclavian artery discovered post-coronary artery bypass grafting surgery. Case summary A 60-year-old man post-LIMA grafting of the left anterior descending (LAD) coronary artery underwent diagnostic cardiac catheterization. Selective angiography revealed occluded LIMA; therefore, it was decided to proceed with percutaneous coronary intervention (PCI) to the occluded native LAD. Once antegrade flow in the LAD was restored, retrograde filling of a vessel corresponding to the previously grafted LIMA was also detected. Additional contrast injection in the left subclavian artery (LSCA) showed a second patent LIMA originating from the distal segment of the LSCA. Discussion This patient has an unusual anatomic variant of two LIMAs originating from the LCSA. The proximal rudimentary LIMA was misinterpreted as an occluded arterial graft while the second, well-developed LIMA connected to the LAD had an unusually distal origin and had therefore been overlooked. This anatomical variant should be kept in mind when the internal mammary graft seems to be occluded.

Sign in / Sign up

Export Citation Format

Share Document