Coronary-subclavian steal syndrome, a complication following surgical revascularization of myocardium


Authors: V. Gloger 1,2
Authors‘ workplace: Klinik für Herz- und Gefäßchirurgie, Herz- und Kreislaufzentrum Rotenburg an der Fulda, Germany, přednosta Privatdozent Dr. Med. Oster Hartmut 1;  Interní klinika IPVZ Praha a Krajské nemocnice Tomáše Bati, a. s., Zlín, přednosta prim. MUDr. Jiří Latta 2
Published in: Vnitř Lék 2012; 58(11): 871-874
Category: Case Reports

Overview

Coronary-subclavian steal syndrom (CSS) is defined as a reversal of flow in a previously constructed internal mammary artery coronary conduit, producing myocardial ischemia. The most often cause is a proximal subclavian artery stenosis or closure. For the first time was CSS described in 1974 and initially was believed to be rare. However, today is the internal mammary artery to the left anterior descending coronary artery used in cardiosurgery as a standard and we can see increasing documentation of this phenomenon. A case report is presented and possibilities of management are discussed in the article.

Key words:
coronary-subclavian steal syndrom – subclavian artery stenosis – coronary artery bypass – internal mammary artery


Sources

1. Harjola PT, Valle M. The Importance of aortic arch or subclavian angiography before coronary reconstruction. Chest 1974; 66: 436–438.

2. Takach TJ, Reul GJ, Cooley DA et al. Myocardial Thievery: The Coronary-Subclavian Steal Syndrom. Ann Thorac Surg 2006; 81: 386–392.

3. Guidelines and indications for coronary artery bypass graft surgery. A report of the American College of Cardiology/American Heart Assosiation Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures [Subcomitee on Coronary Bypass Graft Surgery]. J Am Coll Cardiol 1991; 17: 543–589.

4. Takach TJ, Reul GJ, Duncan JM et al. Concomitant brachiocephalic and coronary artery disease: outcome and decision analysis. Ann Thorac Surg 2005; 80: 564–569.

5. Cardon A, Leclercq C, Brenugat S et al. Coronary subclavian steal syndrome after left internal mammary bypass in a patient with Takayasu´s disease. J Cardiovasc Surg [Torino] 2002; 43: 471–473.

6. Hull MC, Morris CG, Pepine CJ et al. Valvular dysfunction and carotid, subclavian, and coronary artery disease in survivors of Hodgkin lymphoma treatitd with radiation therapy. JAMA 2003; 290: 2831–2837.

7. Crowley SD, Butterly DW, Peter RH et al. Coronary steal from a left internal mammary artery coronary bypass graft by a left upper extremity arteriovenous hemodialysis fistula. Am Kidney Dis 2002; 40: 852–855.

8. McMahon CJ, Thompson KS, Kearney DL et al. Subclavian steal syndrome in anomalous connection of left subclavian artery to the pulmonary artery in d-transposition of the great arteries. Pediatr Cardiol 2001; 22: 60–62.

9. Shadman R, Criqui MH, Bundens WP et al. Subclavian artery stenosis: Prevalence, risk factors, and association with cardiovascular diseases. J Am Coll Cardiol 2004; 44: 618–623.

10. Osborn LA, Vernon SM, Reynolds B et al. Screening for subclavian artery stenosis in patients who are candidates for coronary bypass surgery. Catheter Cardiovasc Interv 2002; 56: 162–165.

11. English JA, Carell ES, Guidera SA et al. Angiographic prevalence and clinical predictors of left subclavian stenosis in patients undergoing diagnostic cardiac cathetrization. Catheter Cardiovac Interv 2001; 54: 8–11.

12. Lobato EB, Kern KB, Bauder-Heit J et al. Incidence of coronary-subclavian steal syndrome in patients undergoing noncardiac surgery. J Cardiothorac Vasc Anesth 2001; 15: 689–692.

13. Rogers JH, Calhoun RF2nd. Diagnosis and management of subclavian artery stenosis prior to coronary artery bypass grafting in the current era. J Card Surg.2007; 22: 20–25.

14. Bilku RS, Khogali SS, Been M. Subclavian artery stenosis as a cause for recurrent angina after LIMA graft stenting. Heart 2003; 89: 1429.

15. Edwards WH. An unsuspected cause for recurrent angina: subclavian artery stenosis. Am Surg 1995; 61: 1057–1060.

16. Komenaka IK, Nguyen ET, Oyogoa SO et al. Subclavian steal syndrome in acute myocardial infarction masquerading as acute embolism to left upper extremity: a case report. Angiology 2004; 55: 209–212.

17. Fitz-Gibbon GM, Keon WJ. Coronary subclavian steal: a recurrent case with notes on detecting the threat potential. Ann Thorac Surg 1995; 60: 1810–1812.

18. Blemker DL, Trippi JA. Coronary-subclavian steal as a cause of dyspnea. Indiana Med 1992; 85: 136–138.

19. Kursaklioglu H, Kose S, Iyisoy A et al. Coronary-subclavian steal syndrome presenting with ventricular tachycardia. Yonsei Med J 2009; 50: 852–855.

20. Bryan FC, Allen RC, Lumsden AB. Coronary-subclavian steal syndrome: report of five cases. Ann Vasc Surg 1995; 9: 115–122.

21. Elian D, Gerniak A, Guetta V et al. Subclavian coronary steal syndrome: an obligatory common fate betwean subclavian artery, internal mammary graft and coronary circulation. Cardiology 2002; 97: 175–179.

22. Bates MC, Broce M, Lavigne PS et al. Subclavian artery stenting: Factors infuencing long-term outcome. Catheter Cardiovasc Interv 2004; 61: 5–11.

23. Tatoulis J, Buxton BF, Fuller JA. Patencies of 2127 arterial to coronary conduits over 15 years. Ann Thorac Surg 2004; 77: 93–101.

24. Takach TJ, Reul GJ, Duncan JM et al. Concomitant brachiocephalic and coronary artery disease: outcome and decision analysis. Ann Thorac Surg 2005; 80: 564–569.

25. Paty PS, Mehta M, Darling RC 3rd et al. Surgical treatment of coronary subclavian steal syndrome with carotid subclavian bypass. Ann Vasc Surg 2003; 17: 22–26.

26. Iwaki H, Kuraoka S, Tatebe S. Coronary subclavian steal syndrome: report of a case. Kyobu Geka 2003; 56: 235–238.

27. Chung DA, Large SR. Relocation of the internal mammary artery graft in a case of coronary-subclavian steal. Thorac Cardiovasc Surg 2000; 48: 39–40.

28. Serryus PW, Morice MC, Kappetein AP et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary disease. N Engl J Med 2009; 360: 961–972.

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Diabetology Endocrinology Internal medicine

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