Concomitant coronary artery bypass grafting and subclavian revascularization
1Department of Cardiovascular Surgery, Osmangazi University Medical School and Research Hospital, Eskişehir, Turkey. ybesogul@gmail.com
Insights
Optimal revascularization for combined coronary artery disease and subclavian artery disease remains unclear. Simultaneous coronary artery bypass grafting (CABG) and aortosubclavian bypass is presented as a potentially effective treatment strategy.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Cardiology
Background:
- Optimal revascularization strategies for patients with concomitant coronary artery disease (CAD) and subclavian artery disease (SAD) are not well-established.
- Limited case reports exist on managing patients with both conditions.
Observation:
- A case of simultaneous surgical treatment involving coronary artery bypass grafting (CABG) and subclavian artery revascularization is presented.
- A prosthetic graft was tunneled through the clavicle to the distal subclavian artery, maintaining pleural integrity.
- The graft was anastomosed to the superior aspect of the subclavian artery.
Findings:
- Simultaneous CABG and aortosubclavian bypass can be technically feasible.
- This combined approach addresses both coronary and upper extremity arterial occlusive disease in a single procedure.
Implications:
- Aortosubclavian bypass combined with CABG may represent an effective therapeutic option for patients with coexisting CAD and SAD.
- This strategy could improve outcomes for a complex patient subset requiring multi-arterial revascularization.
Abstract:
The optimal revascularization strategy for patients with subclavian and coronary artery disease has not yet been established. A few reports exist regarding the management of patients who have both occlusive disease of the subclavian arteries and coronary artery disease. We present a case simultaneously treated with CABG and subclavian artery revascularization. The prosthetic graft was brought to the distal segment of the subclavian artery through the clavicle while keeping the pleura intact and anastomosed to the superior surface of the artery. Aortosubclavian bypass with coronary artery bypass may be an effective option for patients with coexisting subclavian and coronary artery disease.
