FIRST THORACIC ARTERY CORONARY STEAL SYNDROME POST CORONARY ARTERY BYPASS SURGERY

DR. P.C.HALKATI; Dr. S.V. PATTED; Dr. RANJAN MODI; Dr. AMEET SATTUR; Mr. RAJESH TASGAONKAR

Volume : IV, Issue : V, May - 2015

FIRST THORACIC ARTERY CORONARY STEAL SYNDROME POST CORONARY ARTERY BYPASS SURGERY

Dr. P. C. Halkati, Dr. S. V. Patted, Dr. Ranjan Modi, Dr. Ameet Sattur, Mr. Rajesh Tasgaonkar

Abstract :

The use of the arterial and venous vessels as conduits to the native coronary arteries is recommended by the American College of Cardiology/American Heart Association as a coronary bypass graft1. Recurrence of the symptoms post bypass are commonly seen if there is stenosis of the bypass vessel itself , Left internal mammary artery (LIMA) or Saphenous Venous Graft(SVG) ,of the vessel supplying it (Subclavian artery) or compromise of blood flow due to a large anch arisng from the main vessel (Lateral Thoracic artery ). Coronary subclavian steal syndrome (CSSS) is caused by retrograde blood flow through the internal mammary artery graft. Coronary steal due to a large first thoracic artery which is a anch of the internal mammary artery is not well known or documented in literature .We present a series of cases of coiling of the large thoracic artery as therapeutic option for Coronary steal syndrome. We present case reports of four elderly post coronary artery bypass (CABG) patients who underwent first thoracic artery coiling . All patients were similar in the baseline demographic characteristics with LIMA to LAD graft . Two different techniques were used for the procedure , for two patients the multipurpose catheter was used for the deployement of the coil and the rest two underwent the procedure with the use of a microcatheter .