Abstract
We present a case of a 62-year-old man who was in cardiogenic shock. He had a history
of coronary artery bypass grafting 4 years previously, with left internal mammary
radial artery Y-grafting to a left dominant coronary circulation. Critical stenoses
of the left main coronary and left subclavian arteries were seen at angiography. An
occluded abdominal aorta precluded the use of mechanical circulatory support. The
patient underwent high-risk stenting of the left subclavian artery with a successful
outcome. The case highlights the unresolved issue of screening for subclavian stenoses
in patients being considered for revascularization with arterial Y-grafting.
Résumé
Nous présentons le cas d’un homme de 62 ans en choc cardiogénique. Ce patient avait
subi un pontage aortocoronarien 4 ans auparavant, par un montage en Y d’une artère
thoracique et d’une artère radiale internes gauches pour une circulation coronaire
gauche dominante. Une sténose critique de l’artère coronaire gauche principale et
de l’artère subclavière gauche a été observée à l’angiographie. L’occlusion de l’aorte
abdominale écartait le recours à l’assistance circulatoire mécanique. Le patient s’est
soumis à l’installation très risquée d’une endoprothèse dans l’artère subclavière
gauche, intervention qui s’est avérée une réussite. Ce cas met en évidence le problème
non résolu du dépistage des sténoses subclavières lorsque la revascularisation par
un montage en Y des artères est envisagée.
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References
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Article info
Publication history
Published online: June 19, 2019
Accepted:
June 14,
2019
Received:
April 3,
2019
Footnotes
See page 1419.e15 for disclosure information.
Identification
Copyright
© 2019 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
