A Successful Case of Axillo-Axillary Crossover Grafting in a Patient with Coronary Subclavian Steal Syndrome Developing Cardiogenic Shock

(Department of Cardiovascular Surgery, Chugoku Rosai Hospital, Kure, Japan)

Hironori Kobayashi Masafumi Sueshiro Keijiro Katayama
Retrograde flow of the left internal thoracic artery (LITA) secondary to proximal left subclavian artery occlusion or severe stenosis in patients who underwent coronary artery bypass grafting (CABG) using a LITA graft can result in myocardial ischemia. This phenomenon is termed as "coronary subclavian steal syndrome (CSSS)". We report on a successful case of axillo-axillary crossover grafting in a patient with CSSS who suffered cardiogenic shock. A 70-year-old woman had undergone CABG using a LITA graft 10 years previously. The patient developed cardiogenic shock. Emergency angiography revealed retrograde flow of the LITA from the left coronary artery and occlusion of the proximal left subclavian artery. We performed axillo-axillary crossover grafting because anginal pains recurred due to CSSS. The pains disappeared after the operation. This technique appears to be useful in patients with CSSS who suffer cardiogenic shock.
@Jpn. J. Cardiovasc. Surg. 36: 8-11 (2007)