Horowitz M D, Oh C J, Jacobs J P, Chahine R A, Livingstone A S
Department of Surgery, University of Miami/Jackson Memorial Medical Center, Fla.
Ann Vasc Surg. 1993 Sep;7(5):452-6. doi: 10.1007/BF02002129.
Coronary-subclavian steal through an internal mammary artery (IMA) graft is a rare cause of myocardial ischemia in patients who have previously undergone coronary artery bypass surgery. Two patients presented with upper extremity ischemic symptoms and recurrent angina pectoris 3 to 4 years following coronary artery bypass with in situ IMA grafts. Diagnosis of coronary-subclavian steal was confirmed by brachiocephalic arteriography, which showed tight stenosis or occlusion of the proximal subclavian artery. Coronary arteriography showed retrograde filling of the IMA with steal from the coronary circulation. Both patients were successfully treated by carotid-subclavian bypass.
通过乳内动脉（IMA）移植物导致的冠状动脉-锁骨下动脉窃血是既往接受冠状动脉旁路移植术患者发生心肌缺血的罕见原因。两名患者在接受原位IMA移植物冠状动脉旁路移植术后3至4年出现上肢缺血症状和复发性心绞痛。经肱头动脉造影证实为冠状动脉-锁骨下动脉窃血，显示锁骨下动脉近端严重狭窄或闭塞。冠状动脉造影显示IMA逆向充盈，血液从冠状动脉循环中被窃取。两名患者均通过颈动脉-锁骨下动脉旁路移植术成功治疗。
