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Ann Thorac Surg 1977;24:252-257
© 1977 The Society of Thoracic Surgeons

Articles

Subclavian Steal Syndrome in the Pediatric Age Group

Frank M. Midgley, M.D.*, James E. McClenathan, M.D.

From the Department of Cardiovascular Surgery, Children's Hospital National Medical Center, and the Department of Child Health and Development, George Washington University Medical School, Washington, DC

* Address reprint requests to Dr Midgley, Department of Cardiovascular Surgery, Children's Hospital National Medical Center, Washington, DC 20010

Four pediatric patients with subclavian steal syndrome (SSS) are described. One patient with congenital SSS had persistence of the lesion following surgical repair of coarctation of the aorta due to a gradient across a hypoplastic aortic arch. In 3 patients SSS developed on an acquired basis as a sequel to corrective operation, for coarctation in 1 patient, and interrupted aortic arch in 2 patients. Contributory factors included hypoplasia of the aortic arch, anatomical variation of the origin of the vertebral artery, and discrete recoarctation involving the ostium of the subclavian artery. Treatment was by vertebral artery ligation in 3 patients and by prosthetic patch arterioplasty in the patient with recoarctation. The 4 patients remain asymptomatic on follow-up of 16 to 25 months.




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