Acute ST Elevation Myocardial Infarction Following Bypass Graft Surgery: A case of Coronary Subclavian Steal Syndrome (CSSS) Successfully Treated with Percutaneous Intervention

Coronary subclavian steal syndrome (CSSS) is an uncommon complication of coronary artery bypass graft (CABG) surgery when the left internal mammary artery (LIMA) is used in patients with underdiagnosed significant left subclavian artery stenosis (SAS). It is characterized by a retrograde blood flow...

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Published inActa clinica Croatica (Tisak) Vol. 63.; no. Supplement 1; pp. 96 - 99
Main Authors Vito Mustapić, Mladen Predrijevac, Dario Dilber, Luka Rotkvić, Andrija Škopljanac Mačina, Igor Šesto, Krešimir Štambuk
Format Journal Article
LanguageEnglish
Published Sestre Milosrdnice University hospital, Institute of Clinical Medical Research 01.01.2024
Subjects
Acute myocardial infarction with ST segment elevation
Coronary artery bypass graft surgery
Coronary subclavian steal syndrome
Percutaneous intervention
Subclavian artery occlusion
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Summary:Coronary subclavian steal syndrome (CSSS) is an uncommon complication of coronary artery bypass graft (CABG) surgery when the left internal mammary artery (LIMA) is used in patients with underdiagnosed significant left subclavian artery stenosis (SAS). It is characterized by a retrograde blood flow from coronary to subclavian circulation through LIMA graft, causing the “steal” phenomenon and myocardial ischemia. The common presentation is stable angina years after surgery and acute presentation with ST elevation early after surgery is extremely rare. Here we present an unusual and unique presentation of CSSS in a setting of acute ST elevation myocardial infarction treated successfully with complex percutaneous intervention.
ISSN:0353-9466
1333-9451
DOI:10.20471/acc.2024.63.s1.18