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Coronary steal syndrome
J Gayá1, A Del Río Prego, J Guilleuma
1Vascular Surgery Department, Fundación Jiménez Díaz, Madrid, Spain.
Insights
A patient experienced recurrent heart and brain symptoms after coronary bypass surgery due to a left subclavian artery obstruction causing coronary steal syndrome. Surgical bypass successfully relieved these symptoms.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Cardiology
Background:
- Coronary artery bypass grafting (CABG) is a common procedure for ischemic heart disease.
- Complications can arise years after surgery, including rare vascular steal syndromes.
- Left internal mammary artery (IMA) grafts are durable but can be affected by proximal arterial issues.
Abstract:
A patient who suffered recurrent myocardial ischaemia and cerebrovascular symptoms 56 months after a quadruple coronary bypass is reported. Three coronary arteries had been bypassed using reversed saphenous vein and the other using the left internal mammary artery (IMA). Coronary angiography demonstrated patency of al bypasses but the presence of an obstruction of the left subclavian artery proximal to the origin of the left IMA, with angiographic criteria of the steal syndrome. The patient's symptoms were relieved by bypass from the left common carotid artery to the distal left subclavian artery. The pathophysiology, diagnosis, prevention and treatment of coronary steal syndrome are discussed.