Estatísticas

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    "titulo" => "Angina pectoris in a patient with prior coronary artery bypass graft and carotid-subclavian bypass grafting"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">A&#46;</span> Left coronary angiography showing retrograde flow from the coronary tree through the mammary artery bypass graft &#40;arrow&#41;&#46; <span class="elsevierStyleBold">B&#46;</span> Left subclavian angiography revealed total occlusion proximal to the left internal mammary artery graft to the first diagonal artery&#46; <span class="elsevierStyleBold">C&#46;</span> Left common carotid angiography demonstrated the total occlusion of the carotid-subclavian bypass graft &#40;arrow&#41;&#46; <span class="elsevierStyleBold">D&#46;</span> Digital subtraction angiography of the left subclavian artery after stent placement showed successful treatment of the subclavian occlusion&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">D1&#58; first diagonal artery&#59; LAD&#58; left anterior descending artery&#59; LCCA&#58; left common carotid artery&#59; SA&#58; subclavian artery&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 51-year-old man was admitted with exertional chest pain&#46; Eleven years ago&#44; he underwent myocardial revascularization consisting of a left internal mammary artery &#40;LIMA&#41; graft to the first diagonal artery&#46; Seven years ago&#44; he underwent carotid-subclavian bypass surgery due to subclavian artery stenosis&#46; After the second surgery&#44; he was stable&#44; but he developed exertional chest pain last year&#46; His physical examination was remarkable for the presence of weak left radial and brachial pulses&#44; with a significant difference in blood pressure between the right &#40;130&#47;85 mmHg&#41; and left &#40;90&#47;60 mmHg&#41; arms&#46; Electrocardiogram showed normal sinus rhythm without ischemic changes&#46; Contrast injection into the left main coronary artery showed chronic total occlusion of the circumflex artery and demonstrated a striking retrograde flow from the coronary tree through the graft &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure A</a>&#59; Video 1&#41;&#46; A left subclavian artery angiography revealed total occlusion proximal to the origin of the LIMA &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure B</a>&#59; Video 2&#41;&#46; A left common carotid artery angiography showed the total occlusion of the carotid-subclavian bypass graft &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure C</a>&#59; Video 3&#41;&#46; We decided on percutaneous intervention of the left subclavian artery&#44; and the patient was successfully treated with subclavian balloon angioplasty and stent placement &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure D</a>&#59; Video 4-8&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">In this case&#44; we illustrated coronary subclavian steal syndrome in a patient with prior coronary artery bypass graft &#40;CABG&#41; despite carotid-subclavian bypass grafting&#46; Percutaneous intervention with stent implantation was successful&#46; Angina pectoris and differential blood pressure readings in a patient with prior CABG should alert attending physicians to the possibility of this syndrome&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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