Subclavian Steal Syndrome Diagnosed by Color Doppler of the Neck Vessels Prior to Coronary Revascularization. Drastic Change in Surgical Strategy. The Issue of Coronary Steal

pp. 425-428

Abstract

The purpose of this work was to stress the importance of color Doppler studies of supra aortic vessels prior to coronary bypass surgery, after the detection of two cases of subclavian syndromes clinically unrecognized. These finding lead to a drastic change in the surgical strategy. There are reports of coronary steal occurring so close to the coronary surgery that may should have been caused by pre-existing subclavian steal, overlooked in the presurgical examination. In our patients we decided to use other vascular conduits, in the evidence that the treatment of subclavian stenosis has its own morbimortality and recurrence, that itmight increase the risk of the coronary operation and endanger an otherwise favorable outcome. To ignore a subclavian stenosis may later generate a coronary steal, a serious condition easily avoidable by the information provided by a simple, noninvasive and realiable study as color Doppler ultra-sound.