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

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.