A 24-year-old woman with a history of coarctation repair by subclavian flap aortoplasty presented at 15 weeks’ gestation with transient episodes of vision loss. She was diagnosed with subclavian steal syndrome and underwent left carotid artery to subclavian artery bypass at 17 weeks’ gestation. She has had no recurrence of symptoms at ten months of postoperative follow-up. Despite the anatomic substrate for subclavian steal in patients with this type of surgical repair, neurologic symptoms are uncommon. It is possible that the pregnancy-induced fall in systemic vascular resistance triggered symptoms in this previously asymptomatic patient.
SaaloukeMGPerryLWBreckbillDLShapiroSRScottLPIIICerebrovascular abnormalities in postoperative coarctation of aorta. Four cases demonstrating left subclavian steal on aortography. Am J Cardiol. 1978;42(1):97–101.
2.
ChowningSStowellDPonniahU. Carotid-subclavian bypass for subclavian steal syndrome following coarctation repair in infancy. Ann Pediatr Cardiol. 2012;5(2):207–209.
3.
MidgleyFMMcClenathanJE. Subclavian steal syndrome in the pediatric age group. Ann Thorac Surg. 1977;24(3):252–257.
4.
BaudetEal-QudahA. Late results of the subclavian flap repair of coarctation in infancy. J Cardiovasc Surg. 1989;30(3):445–449.
5.
KirklinJWBarratt-BoyesBG. Cardiac Surgery: Morphology, Diagnostic Criteria, Natural History, Techniques, Results, and Indications. 2nd ed. New York, NY: Churchill Livingstone; 1993:1263–1325.
6.
van SonJAvan AstenWNvan LierHJ, et al.Detrimental sequelae on the hemodynamics of the upper left limb after subclavian flap angioplasty in infancy. Circulation. 1990;81(3):996–1004.
7.
ClarkSLCottonDBLeeW, et al.Central hemodynamic assessment of normal term pregnancy. Am J Obstetr Gynecol. 1989;161(6 pt 1):1439–1442.
8.
ClappJFIIICapelessE. Cardiovascular function before, during, and after the first and subsequent pregnancies. Am J Cardiol. 1997;80(11):1469–1473.
