Coronary-Subclavian Steal Syndrome Presenting with Ventricular Tachycardia

다국어 초록 (Multilingual Abstract)

Coronary-subclavian steal through the left internal mammary graft is a rare cause of myocardial ischemia in
patients who have had a coronary bypass surgery. We report a 70-year-old man who presented with sustained
monomorphic ventricular tachycardia 5 years after the surgical creation of a left internal mammary to the left
anterior descending artery. Cardiac catheterization illustrated that the left subclavian artery was occluded
proximally and that the distal course was visualized by retrograde filling through the left internal mammary graft.
Clinical ventricular tachycardia was reproducibly induced with a single ventricular extrastimulus, and
antitachycardia pacing terminated the tachycardia. Restoration of blood flow by way of a Dacron graft placed
between the descending aorta and the subclavian artery resulted in the total relief of symptoms. Ventricular
tachycardia could not be induced during the control electrophysiologic study after surgical revascularization.

다국어 초록 (Multilingual Abstract)

Coronary-subclavian steal through the left internal mammary graft is a rare cause of myocardial ischemia in
patients who have had a coronary bypass surgery. We report a 70-year-old man who presented with sustained
monomorphic ventricular tachycardia 5 years after the surgical creation of a left internal mammary to the left
anterior descending artery. Cardiac catheterization illustrated that the left subclavian artery was occluded
proximally and that the distal course was visualized by retrograde filling through the left internal mammary graft.
Clinical ventricular tachycardia was reproducibly induced with a single ventricular extrastimulus, and
antitachycardia pacing terminated the tachycardia. Restoration of blood flow by way of a Dacron graft placed
between the descending aorta and the subclavian artery resulted in the total relief of symptoms. Ventricular
tachycardia could not be induced during the control electrophysiologic study after surgical revascularization.

참고문헌 (Reference)

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