Cardiogenic shock after arterial Y-graft coronary bypass surgery secondary to critical stenoses of the left subclavian and left main coronary arteries

We present a case of a 62-year-old man who was in cardiogenic shock. He had a history of coronary artery bypass grafting 4 years previously with LIMA-radial artery Y-grafting to a left dominant coronary circulation. Critical stenoses of the left main coronary and left subclavian arteries was seen at angiography. An occluded abdominal aorta precluded the use of mechanical circulatory support. The patient underwent high-risk stenting of the left subclavian artery with a successful outcome. The case highlights the unresolved issue of screening for subclavian stenoses in patients being considered for revascularization with arterial Y-grafting.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research