A rare reason of myocardial ischemia: left subclavian artery stenosis after coronary artery bypass grafting

作者：Colak Necmettin^*; Nazli Yunus; Kirbas Ismail; Eryonucu Beyhan; Cakir Omer

来源：Turkish Journal of Thoracic and Cardiovascular Surgery, 2013, 21(2): 448-450.

DOI：10.5606/tgkdc.dergisi.2013.5320

• Coronary artery bypass grafting
• left subclavian artery stenosis
• myocardial ischemia

A 57-year-old male was admitted with the complaint of prolonged resting angina. His medical history revealed coronary artery bypass grafting (CABG) two years ago. Electrocardiography showed sinus rhythm with a complete left bundle branch block without ST-depression or elevation. Subsequent exercise treadmill testing revealed a significant ST depression in V4-V6 leads. Coronary angiography showed patent bypass grafts, but a critical stenosis of the left subclavian artery just proximal to the origin of the left internal mammary artery. A stent was successfully implanted into the left subclavian artery. It should be considered that subclavian artery stenosis may cause coronary-subclavian steal, leading to myocardial ischemia in patients with a history of coronary artery bypass grafting utilizing a left internal mammary artery.

• 出版日期2013-4