Video 1 Postoperative coronary angiography showing retrograde filling of left mammary artery with steal in subclavian artery
Opmerkingen
Video online
The online version of this article contains one video (https://doi.org/10.1007/s12471-023-01772-5). The video can be found in the article back matter as “Electronic Supplementary Material”.
Coronary artery bypass grafting (CABG) is the cornerstone of treatment of patients with coronary artery disease [1]. The left internal mammary artery (LIMA) is the gold-standard conduit of choice because of its long-term patency [2]. In patients referred for surgery, atherosclerotic disease is not limited to the coronary arteries and often generalised in the vascular system. The presence of stenosis of the subclavian artery, before the LIMA, is an important problem in patients who have undergone CABG. In 1.0% of cases, this phenomenon occurs postoperatively and can lead to recurrent angina [3]. In extreme cases, as presented in the current report (Fig. 1 and see Video 1 in Electronic Supplementary Material), the flow through the LIMA can invert due to postoperative subclavian occlusion, causing ‘subclavian steal’. In most cases, patients exhibit angina after exercise of the upper extremities. Stenting of the subclavian artery or left subclavian artery bypass can be performed to treat this abnormality.
Fig. 1
Still frame of postoperative coronary angiography showing retrograde filling of left mammary artery with steal in subclavian artery
×
Conflict of interest
J. R. Olsthoorn and N. Verberkmoes declare that they have no competing interests.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...
