angioplasty and stenting. Percutaneous intervention has recently gained popularity because it is less invasive. A review by Ribichini et al. (10) summarized the success and safety of percutaneous treatment of these lesions.In our case, there was no steal, but there was severe myocardial ischemia due to diminished blood flow to LIMA in which there was distal subclavian stenosis. A careful evaluation before the operation for preventing of this syndrome is essential.
ConclusionAlthough SAS is very rare and the patients are usually asymptomatic, it has clinical importance in patients with CABG, especially those with composite T-grafting technique. Patients with angina undergoing CABG using LIMA grafting should be considered in terms of left SAS as a possible cause of myocardial ischemia.