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[Coronary subclavian steal syndrome: two cases after coronary artery bypass grafting]

Luit Penninga1, Sune Damgaard

  • 1Rigshospitalet, Thoraxkirurgisk Klinik RT, 2152, DK-2100 København Ø. penninga@dadlnet.com

Ugeskrift for Laeger
|April 15, 2008
PubMed

Insights

Coronary subclavian steal syndrome (CSSS) occurs when internal mammary artery (IMA) flow reverses due to subclavian artery issues after coronary artery bypass grafting (CABG). This case series details two patients diagnosed with CSSS, one treated surgically and the other conservatively.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Coronary subclavian steal syndrome (CSSS) is a complication following coronary artery bypass grafting (CABG).
  • It arises from reverse flow in the internal mammary artery (IMA) graft, caused by proximal ipsilateral subclavian artery stenosis or occlusion.

Observation:

  • Two patients diagnosed with CSSS post-CABG are presented.
  • Patient A exhibited angina pectoris and underwent IMA transposition to the aorta for treatment.
  • Patient B, diagnosed via angiography, showed silent ischemia on myocardial scintigraphy and opted for conservative management.

Findings:

  • CSSS can manifest with symptoms like angina pectoris.
  • Myocardial scintigraphy can reveal silent ischemia in CSSS patients.
  • Treatment strategies for CSSS vary based on patient presentation and symptoms.

Implications:

  • Early diagnosis and appropriate management of CSSS are crucial for preventing myocardial ischemia.
  • Surgical intervention, such as IMA transposition, can effectively treat symptomatic CSSS.
  • Asymptomatic patients with CSSS may be managed conservatively, warranting close monitoring.

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