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Ann Thorac Surg 2001;72:917-919
© 2001 The Society of Thoracic Surgeons

Case report

Impaired flow in left internal mammary artery grafts due to subclavian artery stenosis

Benno Hennen, MDa, Torsten Markwirth, MDa, Bruno Scheller, MDa, Hans-Joachim Schäfers, MDb, Olaf Wendler, MDb

a Department of Cardiology, University Hospitals Homburg/Saar, Homburg/Saar, Germany
b Department of Thoracic and Cardiovascular Surgery, University Hospitals Homburg/Saar, Homburg/Saar, Germany

Accepted for publication August 23, 2000.

Address reprint requests to Dr Hennen, Medizinische Klinik III (Kardiologie/Angiologie), Universitätskliniken des Saarlandes, Kirrberger Strasse 1, 66421 Homburg/Saar, Germany
e-mail: hennen{at}med-in.uni-sb.de

We report two cases of patients with left internal mammary artery (LIMA) grafts impaired by proximal stenosis of the subclavian artery. The functional impact of the subclavian lesions was investigated using flow-wire. The hemodynamic relevance of the lesions could be documented with the functional flow measurements in both instances. The relevance of preoperative evaluation of the subclavian artery is emphasized when it is planned to use the LIMA as coronary bypass. Moreover, the case reports indicate that percutaneous intervention of the subclavian artery is an effective treatment modality to restore adequate flow in the LIMA.




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