A Surgical Case of CABG with Subclavian Steal Syndrome and Bilateral Iliac Type ASO

(Department of Cardiovascular Surgery, Kawachi General Hospital, Higashiosaka, Japan)

Takahiro Yamaguchi Naruto Matsuda
Ischemic heart disease (IHD) may coexist with aorto-iliac occlusive disease, and concomitant revascularization procedures may be required. This study reports our experience with ascending aorta to left femoral bypass grafting (Ao-ltFG) to prepare for intra-aortic balloon pumping (IABP). A 73-year-old man with chest pain was admitted to our hospital. Coronary angiography revealed coronary aneurysm and IHD. Enhanced computed tomography showed coronary aneurysm, complete left subclavian artery occlusion and bilateral external iliac artery occlusion. We planned a two-stage operation. In the first operation, we chose coronary artery bypass grafting, excision of the coronary aneurysm and simultaneously Ao-ltFG to prepare for IABP. In the second operation, we chose axillo-axillo bypass grafting and Ao-ltFG to right femoral artery bypass grafting. Although in the operative findings no coronary aneurysm was recognized, we performed the other operations and the postoperative course was uneventful without IABP.
@Jpn. J. Cardiovasc. Surg. 37: 128-131 (2008)