Lateral costal artery as a culprit for the steal phenomenon after coronary artery bypass grafting: a case report and review of the literature
Abstract Background The left internal thoracic artery (LITA) has been widely accepted as the standard for revascularizing the left anterior descending artery during coronary artery bypass grafting (CABG) surgery. However, in 10–20% of cases, the LITA may lead to unsecured side branches to the chest...
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| Format: | Article |
| Language: | English |
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BMC
2025-01-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-024-03273-x |
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| author | Michal Trebišovský Marián Homola Adrián Kolesár Štefan Lukačin Anton Bereš |
| author_facet | Michal Trebišovský Marián Homola Adrián Kolesár Štefan Lukačin Anton Bereš |
| author_sort | Michal Trebišovský |
| collection | DOAJ |
| description | Abstract Background The left internal thoracic artery (LITA) has been widely accepted as the standard for revascularizing the left anterior descending artery during coronary artery bypass grafting (CABG) surgery. However, in 10–20% of cases, the LITA may lead to unsecured side branches to the chest wall, particularly the lateral costal artery (LCA), potentially resulting in postoperative chest angina. Case presentation We report the case of a 58-year-old patient who experienced persistent angina eight months after having undergone coronary artery bypass grafting (CABG) due to the steal phenomenon caused by a thick lateral costal artery (LCA). The LCA was found to be 2/3 the diameter of the left internal thoracic artery (LITA) with the decision to obliterate the LCA. Following LCA obliteration, the patient’s exertional angina was resolved. Conclusions LCA may pose a potential issue in terms of coronary steal after CABG. Understanding the anatomy of the LITA with LCA variation and widening the opening of the pleura may be beneficial in preventing postoperative steal in selected cases. |
| format | Article |
| id | doaj-art-47d0d70ac8144734a12a1b4ecae97f4d |
| institution | Kabale University |
| issn | 1749-8090 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-47d0d70ac8144734a12a1b4ecae97f4d2025-01-12T12:39:13ZengBMCJournal of Cardiothoracic Surgery1749-80902025-01-012011410.1186/s13019-024-03273-xLateral costal artery as a culprit for the steal phenomenon after coronary artery bypass grafting: a case report and review of the literatureMichal Trebišovský0Marián Homola1Adrián Kolesár2Štefan Lukačin3Anton Bereš4Department of Heart Surgery, East Slovak Institute for Cardiovascular DiseasesDepartment of Heart Surgery, East Slovak Institute for Cardiovascular DiseasesDepartment of Heart Surgery, East Slovak Institute for Cardiovascular DiseasesDepartment of Heart Surgery, East Slovak Institute for Cardiovascular DiseasesDepartment of Heart Surgery, East Slovak Institute for Cardiovascular DiseasesAbstract Background The left internal thoracic artery (LITA) has been widely accepted as the standard for revascularizing the left anterior descending artery during coronary artery bypass grafting (CABG) surgery. However, in 10–20% of cases, the LITA may lead to unsecured side branches to the chest wall, particularly the lateral costal artery (LCA), potentially resulting in postoperative chest angina. Case presentation We report the case of a 58-year-old patient who experienced persistent angina eight months after having undergone coronary artery bypass grafting (CABG) due to the steal phenomenon caused by a thick lateral costal artery (LCA). The LCA was found to be 2/3 the diameter of the left internal thoracic artery (LITA) with the decision to obliterate the LCA. Following LCA obliteration, the patient’s exertional angina was resolved. Conclusions LCA may pose a potential issue in terms of coronary steal after CABG. Understanding the anatomy of the LITA with LCA variation and widening the opening of the pleura may be beneficial in preventing postoperative steal in selected cases.https://doi.org/10.1186/s13019-024-03273-xLeft internal mammary arteryCoronary artery bypass graftingCardiac surgeryLateral costal arteryRevascularization |
| spellingShingle | Michal Trebišovský Marián Homola Adrián Kolesár Štefan Lukačin Anton Bereš Lateral costal artery as a culprit for the steal phenomenon after coronary artery bypass grafting: a case report and review of the literature Journal of Cardiothoracic Surgery Left internal mammary artery Coronary artery bypass grafting Cardiac surgery Lateral costal artery Revascularization |
| title | Lateral costal artery as a culprit for the steal phenomenon after coronary artery bypass grafting: a case report and review of the literature |
| title_full | Lateral costal artery as a culprit for the steal phenomenon after coronary artery bypass grafting: a case report and review of the literature |
| title_fullStr | Lateral costal artery as a culprit for the steal phenomenon after coronary artery bypass grafting: a case report and review of the literature |
| title_full_unstemmed | Lateral costal artery as a culprit for the steal phenomenon after coronary artery bypass grafting: a case report and review of the literature |
| title_short | Lateral costal artery as a culprit for the steal phenomenon after coronary artery bypass grafting: a case report and review of the literature |
| title_sort | lateral costal artery as a culprit for the steal phenomenon after coronary artery bypass grafting a case report and review of the literature |
| topic | Left internal mammary artery Coronary artery bypass grafting Cardiac surgery Lateral costal artery Revascularization |
| url | https://doi.org/10.1186/s13019-024-03273-x |
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