Martínez-Dolz L, Sáncheza E, Almenar L, Arnau M A, Osa A, Palencia M
Servicio de Cardiología y aUnidad de Radiología Vascular Intervencionista, Hospital Universitario La Fe, Valencia, Spain.
Rev Esp Cardiol. 2001 Jul;54(7):920-3. doi: 10.1016/s0300-8932(01)76421-4.
The coronary-subclavian steal syndrome is a rare cause of recurrent myocardial ischemia in patients who have undergone left internal mammary-coronary artery bypass grafting. A significant left subclavian artery stenosis proximal to its origin, can result in an impaired or reversed flow in this graft and myocardial ischemia. We describe the case of a woman aged 76 who had undergone myocardial revascularization seven months before, and presented refractory angina with severe electrocardiographic ischemia in the left anterior descending artery territory. Arteriography confirmed this syndrome and the patient was successfully treated with percutaneous transluminal angioplasty and placement of two stents in the left subclavian artery. We review the clinical management, diagnostic methods and therapeutic options used in the subclavian-coronary steal syndrome.
冠状动脉-锁骨下动脉窃血综合征是接受左乳内动脉-冠状动脉旁路移植术患者反复发生心肌缺血的罕见原因。左锁骨下动脉起始部近端严重狭窄可导致该移植血管血流受损或逆流,进而引起心肌缺血。我们报告一例76岁女性患者,该患者在7个月前接受了心肌血运重建术,现出现难治性心绞痛,左前降支动脉区域有严重的心电图缺血表现。血管造影证实了该综合征,患者经皮腔内血管成形术及在左锁骨下动脉置入两枚支架后成功治愈。我们回顾了锁骨下-冠状动脉窃血综合征的临床处理、诊断方法及治疗选择。