[A case of congenital subclavian steal]

A case of congenital subclavian steal is reported. A 7-year-old girl was admitted on July 1980 to Shimane Medical University for evaluation of murmur over the region of the chest. Heart murmur was pointed out at the age of three month, however, she had no complaints and was growing normally. On admission, the blood pressure was 108/48 mmHg in the left arm and unobtainable in the right arm. The length of the arm was 53 cm on the right side and 55.4 cm on the left side. On auscultation, a systolic murmur was present over the chest and the right neck. The arch aortography disclosed the left aortic arch, the isolation of the right subclavian artery and the right patent ductus arteriosus (PDA). The left transfemoral vertebral angiography showed the retro-grade filling from the right vertebral artery to the right subclavian and pulmonary artery via the right PDA. The right external carotid angiography showed the filling of the right vertebral artery through muscular branches of the right occipital artery. The right retrograde brachial angiography showed small right subclavian artery and the filling of the pulmonary artery through the right PDA. The recorrective operation was made. Postoperatively, normal blood flow was recognized in angiography. The blood pressure improved in the right side and the murmur was diminished.