Two cases of internal thoracic artery side-branch ligation in patients with recurrent angina after coronary bypass are reported with long-term follow-up. Ligation was performed with clips via a left thoracotomy. Treadmill stress testing after 3 and 4 years did not provoke any myocardial ischemia. These findings suggest that an unligated side-branch can produce a steal phenomenon.
Get full access to this article
View all access options for this article.
References
1.
HorowitzMDOhCJJacobsJPChahineRALivingstoneAS. Coronary-subclavian steal: a cause of recurrent myocardial ischemia. Ann Vasc Surg1993; 7: 452–6.
MorocuttiGGaspariniDSpedicatoLGelsominoSPaparellaGBernardiG. Functional evaluation of steal by unligated first intercostal branch before transcatheter embolization in recurrent angina after a LIMA-LAD graft. Cathet Cardiovasc Interv2002; 56: 373–6.
4.
PagniSBousamraM2ndShirleyMWSpencePA. Successful VATS ligation of a large anomalous branch producing IMA steal syndrome after MIDCAB. Ann Thorac Surg2001; 71: 1681–2.
5.
GaudinoMSerricchioMTondiPGliecaFBrunoPPossatiG. Do internal mammary artery side-branches have the potential for haemodynamically significant flow steal?Eur J Cardiothorac Surg1999; 15: 251–4.
6.
KernMJ. Mammary side branch steal: is this a real or even clinically important phenomenon?Ann Thorac Surg1998; 66: 1873–5.
7.
SoliotisFAl-KutoubiAHandlerCE. Transbranchial coil occlusion of the first intercostal branch of an internal mammary artery bypass graft for angina. Int J Cardiol1997; 59: 206–8.
8.
HartzRSHeuserRR. Embolization of IMA side branch for post-CABG ischemia. Ann Thorac Surg1997; 63: 1765–6.