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Although atherosclerotic disease of the subclavian artery has previously been reported to cause coronary-subclavian steal syndrome, acute myocardial infarction because of occlusion of the subclavian artery in a graft-dependent coronary circulation is an uncommon and previously unreported mode of clinical presentation. Increasingly, patients undergoing high-risk cardiopulmonary procedures have comorbidities with extensive atherosclerotic disease of many vascular beds including coronary, cranial, and peripheral. Our discussion reviews the clinical presentation of such a case and highlights some of the important treatment options available when confronted with such a finding. The successful outcome achieved by percutaneous stenting of the subclavian artery and salvage of the graft may indicate that this modality is the initial treatment of choice in such cases. |
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