Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Rare causes of return angina, after coronary artery bypass surgerywith internal thoracic artery grafting: steal syndrome lateralbranches internal thoracic artery, сoronary-subclavian steal syndrome,thoracic outlet syndrome

Authors: A.V. Kazaryan, I.Yu. Sigaev

Company:
Bakoulev National Scientific and Practical Center for Cardiovascular Surgery, Ministry of Health of the Russia, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2017-14-1-5-14

UDC: 616.12-009.72-06:616.132.2-089.843.031

Link: Clinical Physiology of Blood Circulaiton. 2017; 14 (1): 5-14

Quote as: Kazaryan A.V., Sigaev I.Yu. Rare causes of return angina, after coronary artery bypass surgery with internal thoracic artery grafting: steal syndrome lateral branches internal thoracic artery, coronary-subclavian steal syndrome, thoracic outlet syndrome. Klinicheskaya Fiziologiya Krovoobrashcheniya (Clinical Physiology of Circulation, Russian journal). 2017; 14 (1): 5–14 (in Russ.).

Received / Accepted:  08.11.2016/23.11.2016

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Abstract

Maximum use of arterial conduits, exception technical errors when applying the anastomosis, having a good distal parts grafted arteries, adequate medical therapy in postoperative period can achieve good results, after coronary artery bypass grafting. However, in referring to the aggressive flow of atherosclerosis through a certain number of years after the surgery, some patients have noted the return angina pectoris. This is usually due to the progression of atherosclerosis, in which are involved, as well as post-production, and coronary arteries (grafted and not-grafted). Among the reasons for the return angina pectoris in the first place shunts dysfunction (57–73%), followed by the progression of atherosclerosis in native or grafted coronary arteries (12–23%) the original incomplete myocardial revascularization (5–8%). Repeated bouts of angina pectoris in patients after coronary bypass surgery operation that used internal thoracic artery (ITA), according to bypass are due for the most part not defeat blood conduit, and the progression of atherosclerosis in the coronary arteries distal to the anastomosis. However, in addition to the main causes of dysfunction ITA graft, there are rare causes of return angina, such as steal syndrome lateral branches ITA, coronary-subclavian steal syndrome, thoracic outlet syndrome.

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