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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2002 August;43(4):471-3

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Coronary subclavian steal syndrome after left internal mammary bypass in a patient with Takayasu’s disease

Cardon A. 1, Leclercq C. 2, Brenugat S. 1, Jego P. 3, Kerdiles Y. 1

1 Service de Chirurgie Vasculaire, CHRU 2 Départment de Cardiologie, Centre Cardio-Pneumologique, Hôpital Pontchaillou, CHRU 3 Service de Médecine G, CHRU, Rennes, France


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We ­report the ­case of a 56-­year-old symp­to­matic ­women who under­went 2 cor­o­nary ­bypasses (­left ­internal mam­mary ­artery on the ­left ante­rior ­artery and saph­e­nous ­venous ­bypass on the cir­cum­flex) for a ­tight sten­osis of the ­left ­main cor­o­nary. An inflam­ma­tory syn­drome had ­been ­explored for 1 ­year ­without spe­cific diag­nosis. ­Eight ­months ­later, cor­o­nary angio­graphy was per­formed for recur­rence of ­angina: ­both ­bypasses ­were ­patent ­without sten­osis and the ­left ­main sten­osis was ­unchanged, but sig­nif­i­cant sten­osis of the sub­cla­vian ­artery was ­found ­just ­before the ­LIMA. The diag­nosis of ­Takayasu’s dis­ease was sus­pected in accor­dance ­with the ARC cri­teria and cor­ti­cos­ter­oids ­were ­started. One ­year ­later, ­because of recur­rent ­angina, the ­patient was sur­gi­cally ­treated ­with sub­cla­vian, ver­te­bral and ­internal mam­mary endo­fi­brec­tomy and an ­inverted saph­e­nous ­vein ­graft ­from the sub­cla­vian to the axil­lary ­artery for exten­sive ­supra-­aortic ­lesions. The ­patient ­remains ­symptom ­free at 1 ­year ­follow-up.

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