Document Detail

Coronary-subclavian steal phenomenon late after coronary artery bypass grafting: an underappreciated cause of myocardial ischemia?
MedLine Citation:
PMID:  19412120     Owner:  NLM     Status:  MEDLINE    
Coronary-subclavian steal (CSS) is an increasingly reported phenomenon after coronary artery bypass graft (CABG) operation and it is caused by proximal subclavian artery stenosis in patients with internal thoracic artery grafts. We discuss briefly the diagnostic strategies to rule out significant subclavian stenosis before CABG and, in the follow-up, the importance of subclinical detection of coronary-subclavian steal before the potential onset of myocardial ischemia. Although the most appropriate management of concomitant brachiocephalic and coronary artery disease remains a matter of debate, patients developing CSS syndrome after CABG can be treated successfully by both surgical and percutaneous techniques. Retrospective analysis of surgical databases will help to identify the predictors, if any, of subclavian artery disease progression in candidates for internal thoracic artery grafting, in order to choose a tailored surgical approach.
Alessandro Migliorato; Giuseppe Andò; Antonio Micari; Sergio Baldari; Francesco Arrigo
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  10     ISSN:  1558-2027     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-05-28     Completed Date:  2009-07-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  578-80     Citation Subset:  IM    
Department of Medicine and Pharmacology, Cardiology Section, Italy.
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MeSH Terms
Coronary Angiography
Coronary Artery Bypass / adverse effects*
Myocardial Ischemia / etiology*,  pathology,  therapy
Subclavian Steal Syndrome / etiology*,  pathology,  therapy
Tomography, Emission-Computed, Single-Photon

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