Chest
Volume 66, Issue 4, October 1974, Pages 436-438
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SELECTED REPORTS
The Importance of Aortic Arch or Subclavian Angiography Before Coronary Reconstruction

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We report a patient with marked atherosclerotic stenosis in the left subclavian artery and a previous anastomosis of the left internal mammary artery to the anterior descending branch of the left coronary artery. The importance of the aortic arch or subclavian angiography before reconstructive operation is discussed.

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CASE REPORT

A 57-year-old man with previous myocardial infarction and severe angina pectoris was admitted to the surgical ward, because selective coronary angiography showed significant atherosclerotic changes in all three main coronary branches. On physical examination before operation no bruits were audible on the branches of the aortic arch. The blood pressure (170/100 mm Hg) was measured on one arm only. In coronary reconstruction on Oct 4,1972, the right coronary artery and the left circumflex branch

DISCUSSION

Besides the conventional aortocoronary venous bypass graft, anastomosis of the internal mammary artery to a coronary artery branch is more and more frequently used in coronary artery reconstructions.2, 4

Recently, investigations were reported suggesting that the prognosis of the mammary artery grafts is better than that of the vein grafts.5, 6

A marked stenosis in the innominate, subclavian or internal mammary arteries may reduce the blood flow in the mammary artery grafts in a hazardous way.

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