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Eur J Cardiothorac Surg 2002;21:108-110
© 2002 Elsevier Science NL

Case report

Reoperative revascularization of an occluded left subclavian artery and left internal mammary artery ostial stenosis

^a I.R.C.C.S NEUROMED, Via Atinense N.18, 86077 (ISERNIA), Pozzilli, Italy
^b Divisione di Cardiochirurgia, Policlinico Careggi, Firenze, Italy

Received 17 July 2001; received in revised form 2 October 2001; accepted 14 October 2001.

* Corresponding author: Fax: +39-573-985427
e-mail: mbonacchi{at}hotmail.com

An ostial stenosis of the left internal mammary artery graft anastomosed to the left anterior descending artery was responsible for unstable angina in a patient with a previous coronary artery bypass graft. A T-shape arterectomy was performed between the left subclavian artery and left internal mammary artery. Successful revascularization of the lesion was achieved with a carotid-to-subclavian bypass and surgical ostial plasty extending to the proximal left internal mammary graft using a Hemashild a graft. This procedure was performed through a transverse supraclavicular incision to avoid potential hazards of a redo median sternotomy.

Key Words: Left internal mammary artery • Ostial stenosis • Subclavian steal syndrome

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