Coronary Subclavian Steal Syndrome: A Contemporary Review
Hassan M Lak1, Rohan Shah2, Beni Rai Verma1
1Department of Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
Insights
Coronary subclavian steal syndrome (CSSS) is a rare angina cause in patients with prior bypass grafting. This condition involves retrograde blood flow in a left internal mammary artery (LIMA) graft, potentially compromising heart perfusion.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Coronary subclavian steal syndrome (CSSS) is a rare complication following coronary artery bypass grafting (CABG).
- It specifically affects patients with a left internal mammary artery (LIMA) to left anterior descending (LAD) artery graft and concurrent subclavian artery stenosis.
- This anatomical configuration can lead to retrograde flow in the LIMA graft.
Abstract:
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.
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