Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지
DOI QR코드

DOI QR Code

Post-Coronary Artery Bypass Grafting Myocardial Ischemia Caused by an Overgrown Left Internal Thoracic Artery Side Branch

  • Kim, Eung Re (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Oh, Se Jin (Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center) ;
  • Kang, Hyun-Jae (Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, Ki-Bong (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine)
  • Received : 2014.05.12
  • Accepted : 2014.07.18
  • Published : 2014.10.05
Download PDF
⟨ Previous Next ⟩

Abstract

We present a patient who developed recurrent angina after coronary artery bypass grafting (CABG). Myocardial single-photon emission computed tomography (SPECT) demonstrated deterioration in the myocardial perfusion, and coronary angiography revealed an overgrown side branch of the grafted left internal thoracic artery (ITA); otherwise, there were no significant changes compared with previous imaging studies obtained after the CABG. After percutaneous embolization of the grafted left ITA side branch, the angina was resolved and myocardial SPECT showed improved perfusion.

Keywords

References

  1. Barner HB, Standeven JW, Reese J. Twelve-year experience with internal mammary artery for coronary artery bypass. J Thorac Cardiovasc Surg 1985;90:668-75.
  2. Cameron A, Kemp HG Jr, Green GE. Bypass surgery with the internal mammary artery graft: 15 year follow-up. Circulation 1986;74(5 Pt 2):III30-6.
  3. Bauer EP, Bino MC, von Segesser LK, Laske A, Turina MI. Internal mammary artery anomalies. Thorac Cardiovasc Surg 1990;38:312-5. https://doi.org/10.1055/s-2007-1014041
  4. Chalvatzoulis E, Ananiadou O, Madesis A, Christoforidis T, Katsaridis V, Drossos G. Unligated left internal mammary artery side branch resulting in coronary artery steal syndrome. J Card Surg 2011;26:487-90. https://doi.org/10.1111/j.1540-8191.2011.01297.x
  5. Abdo N, Curran PJ, Kumar V, Tobis JM. Coronary steal syndrome with coil embolization of a large LIMA side branch: radionuclide evidence for reversible ischemia. Catheter Cardiovasc Interv 2005;66:360-3. https://doi.org/10.1002/ccd.20501
  6. Gaudino M, Serricchio M, Tondi P, et al. Do internal mammary artery side-branches have the potential for haemodynamically significant flow steal? Eur J Cardiothorac Surg 1999;15:251-4. https://doi.org/10.1016/S1010-7940(99)00021-4
  7. Guzon OJ, Klatte K, Moyer A, Khoukaz S, Kern MJ. Fallacy of thoracic side-branch steal from the internal mammary artery: analysis of left internal mammary artery coronary flow during thoracic side-branch occlusion with pharmacologic and exercise-induced hyperemia. Catheter Cardiovasc Interv 2004;61:20-8. https://doi.org/10.1002/ccd.10722
  8. Pagni S, Bousamra M 2nd, Shirley MW, Spence PA. Successful VATS ligation of a large anomalous branch producing IMA steal syndrome after MIDCAB. Ann Thorac Surg 2001; 71:1681-2. https://doi.org/10.1016/S0003-4975(00)02300-6

Cited by

  1. Left internal mammary artery side branch intervention in the management of coronary steal syndrome following coronary artery bypass grafting vol.97, pp.1, 2021, https://doi.org/10.1002/ccd.28630
  2. Utilization and outcomes of transcatheter coil embolization for various coronary artery lesions: Single‐center 12‐year experience vol.98, pp.7, 2021, https://doi.org/10.1002/ccd.29381