Coronary-Subclavian Steal Syndrome Following CABG: a Case Report and Literature Review

Coronary-subclavian steal syndrome (CSSS) is not a common complication but it can cause recurrent angina following coronary artery bypass grafting (CABG). CSSS results from proximal subclavian artery stenosis causing reversal of blood flow in a patent in situ internal thoracic artery utilized as a conduit in CABG, leading to myocardial ischemia. We present a case of CSSS successfully treated with carotid-subclavian bypass (CSB). A review of articles on the subject has also been conducted. Although CSSS is not a common condition, it should be strongly considered as a possibility in CABG patients presenting with recurrent chest pain not to be confused with perioperative myocardial infarction (PMI). If indicated, carotid-subclavian bypass may be performed as an effective treatment option with acceptable outcomes.