Congenital Subclavian Steal Syndrome Research Articles

Congenital Subclavian Steal Syndrome Associated With Heterotaxy Syndrome and Atrioventricular Septal Defect

An infant under follow-up evaluation since the fetal stage was detected to have subclavian steal syndrome (SSS) associated with heterotaxy syndrome and atrioventricular septal defect. Such a complex association has not been reported previously. Congenital SSS occurs as a result of a subclavian artery originating from the main pulmonary artery through the ductus instead of the aortic arch. In rare cases, as in the reported case, it may occur due to proximal segment atresia of the left subclavian artery.

Robert James Graves and the cardiovascular responses to postural changes in heart failure

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Cerebral Ischemia Due to Congenital Malformations of Brachiocephalic Arteries

Seven cases of congenital anomalies of brachiocephalic arteries are presented; malfor mations include unilateral absence of the internal carotid artery (ICA) (n = 3), unilat eral hypoplasia of the ICA (n = 2), agenesis of the innominate artery (n = 1), and atresia of the subclavian artery (n = 1). All patients but 1 exhibited symptoms of cerebrovas cular insufficiency at the time of radiologic investigation; they were not affected by other cardiovascular malformations, except right aortic arch in 2 cases and left cervical arch in another case. Two patients suffering from congenital subclavian steal syndrome underwent surgery to correct the vascular malformations. Embryogenesis and natural history of such malformations are briefly discussed.

Congenital subclavian steal syndrome with anomaly of the aortic arch

A case of congenital subclavian steal syndrome associated with an anomalous right-sided aorta is reported. A 41-year-old man complaining of vertigo and a loss of consciousness was admitted. Physical examination revealed a blood pressure differential between the arms that was 20 mm Hg less in the left. Aortography showed a right aortic arch from which arose the right subclavian and both common carotid arteries. The left subclavian artery did not opacify. Right vertebral angiography showed retrograde filling of the left vertebral. A left carotid-subclavian by-pass was performed. Postoperatively, the patient is symptom free with equalized blood pressure.

Cerebral Ischemia Due to Congenital Malformations of Brachiocephalic Arteries—Case Reports

Seven cases of congenital anomalies of brachiocephalic arteries are presented; malformations include unilateral absence of the internal carotid artery (ICA) (n = 3), unilateral hypoplasia of the ICA (n = 2), agenesis of the innominate artery (n = 1), and atresia of the subclavian artery (n = 1). All patients but 1 exhibited symptoms of cerebrovascular insufficiency at the time of radiologic investigation; they were not affected by other cardiovascular malformations, except right aortic arch in 2 cases and left cervical arch in another case. Two patients suffering from congenital subclavian steal syndrome underwent surgery to correct the vascular malformations. Embryogenesis and natural history of such malformations are briefly discussed.

Bull-Worker syncopy: Congenital subclavian steal syndrome following isometric exercise

A patient with congenital great artery abnormality facilitating subclavian steal is presented. Sustained isometric upper body exercise, using a "Bull-Worker," resulted in vertebrobasilar steal symptoms (subclavian steal syndrome) shortly after exercise. A mechanism for the timing of symptoms following isometric exercise is suggested.

Subclavian Steal Syndrome in the Pediatric Age Group

Four pediatric patients with subclavian steal syndrome (SSS) are described. One patient with congenital SSS had persistence of the lesion following surgical repair of coarctation of the aorta due to a gradient across a hypoplastic aortic arch. In 3 patients SSS developed on an acquired basis as a sequel to corrective operation, for coarctation in 1 patient, and interrupted aortic arch in 2 patients. Contributory factors included hypoplasia of the aortic arch, anatomical variation of the origin of the vertebral artery, and discrete recoarctation involving the ostium of the subclavian artery. Treatment was by vertebral artery ligation in 3 patients and by prosthetic patch arterioplasty in the patient with recoarctation. The 4 patients remain asymptomatic on follow-up of 16 to 25 months.

Congenital Subclavian Steal Syndrome; Anatomy, Physiology, Pathology and Surgical Correction

A 22-year old man with right aortic arch and congenital subclavian steal syndrome secondary to hypoplastic malformation of the left subclavian artery proximal to the ostium of the vertebral artery is presented. Surgical correction of the hypoplastic segment was performed with the use of knitted Dacron graft. The patient has subsequently been asymptomatic, and the graft is patent as demonstrated by postoperative aortography.