Review of Coronary-Subclavian Steal Following Internal Mammary Artery—Coronary Artery Bypass Surgery

Myocardial ischaemia due to stenosis of the subclavian artery

“…Similar findings were discovered by other authors, who classified them as subclavian-coronary steal syndrome [9]. Regardless of the chronic character of cardiac ischaemia symptoms in a majority of cases, some patients may develop an acute coronary syndrome [9][10][11]14]. This was actually the case of the patient described herein, or at least his symptoms of acute coronary insufficiency were aggravated by coexistent stenosis of the subclavian artery.…”

“…Normalization of the blood pressure in patients with subclavian-coronary steal syndrome rarely caused significant clinical symptoms. A few publications note claudication of the left upper limb [10,11,14]. Routine examination of the blood pressure on both arms is supposed to identify a group of patients in whom subclavian stenosis is likely [15].…”

“…In these patients coronary arteriography ought to be supplemented with aortic arch imaging [15]. However, identical bilateral pressure on upper limbs confirmed prior to cardiac surgery does not preclude a possibility of development of steal syndrome during the post-operative course [11,14].…”

“…Traditional surgical methods of treatment for subclavian-coronary steal syndrome involve a bypass from the left common carotid artery and left subclavian artery [12,14,15]. As in other diseases formerly treated with surgery, such as portal hypertension, progress in minimally invasive techniques brought about a change in treatment of this syndrome.…”

Coronary-Subclavian Steal Syndrome: A Rare Cause of Angina Pectoris

“…The incidence of CSSS has increased the last years from 0.5% [2,3] to 3.4% [4] in patients who undergo CABG using the LIMA as a conduit bypass graft. Ischemic symptoms can present immediately following CABG surgery or up to 7 years later [2,3]. Symptoms of CSSS may include angina, vertigo, and syncope with left arm exercising.…”