ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
A rare reason of myocardial ischemia: left subclavian artery stenosis after coronary artery bypass grafting
Necmettin Çolak1, Yunus Nazlı1, İsmail Kırbaş2, Beyhan Eryonucu3, Ömer Çakır1
1Department of Cardiovascular Surgery, Medical Faculty of Fatih University, Ankara, Turkey
2Department of Radiology, Medical Faculty of Fatih University, Ankara, Turkey
3Department of Cardiology, Medical Faculty of Fatih University, Ankara, Turkey
DOI : 10.5606/tgkdc.dergisi.2013.5320
A 57-year-old male was admitted with the complaint of prolonged resting angina. His medical history revealed coronary artery bypass grafting (CABG) two years ago. Electrocardiography showed sinus rhythm with a complete left bundle branch block without ST-depression or elevation. Subsequent exercise treadmill testing revealed a significant ST depression in V4-V6 leads. Coronary angiography showed patent bypass grafts, but a critical stenosis of the left subclavian artery just proximal to the origin of the left internal mammary artery. A stent was successfully implanted into the left subclavian artery. It should be considered that subclavian artery stenosis may cause coronary-subclavian steal, leading to myocardial ischemia in patients with a history of coronary artery bypass grafting utilizing a left internal mammary artery.
Keywords : Coronary artery bypass grafting; left subclavian artery stenosis; myocardial ischemia
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