Coronary-subclavian steal syndrome, an easily overlooked entity in interventional cardiology

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Medical Complications

Background:

• Coronary-subclavian steal syndrome (CSSS) is a rare but severe complication following coronary artery bypass grafting (CABG) that utilizes internal mammary artery grafts.
• It arises from proximal subclavian artery stenosis, leading to reversed blood flow in the graft and myocardial ischemia.

Observation:

• This review synthesizes existing literature on CSSS and presents a case series of five consecutive patients.
• The cases highlight the diverse clinical manifestations of CSSS, underscoring the need for heightened clinical suspicion.

Findings:

• Proximal subclavian artery stenosis is the underlying cause of CSSS, impacting graft function.
• The clinical presentation of CSSS can be highly variable, making diagnosis challenging.

Implications:

• Increased awareness of CSSS among clinicians treating CABG patients is essential for timely diagnosis and intervention.
• Prompt recognition and management of CSSS can prevent adverse cardiovascular events and improve patient outcomes.