Case Report: Left Internal Mammary Artery (LIMA)/Coronary Steal Syndrome (CSS) in Severe Coronary Artery Disease and End-Stage Renal Disease

Authors

Fahed Alsayed, HCA HealthcareFollow
Muhannad Badran, HCA HealthcareFollow
Sara Khasawneh
Mohan Sengodan, HCA HealthcareFollow

Files

Division

North Texas

Hospital

Medical City Arlington

Specialty

Internal Medicine

Document Type

Poster

Publication Date

2025

Keywords

coronary steal syndrome, coronary artery disease, ends-stage renal disease, kidney disease

Disciplines

Cardiovascular Diseases | Internal Medicine | Male Urogenital Diseases | Medicine and Health Sciences

Abstract

Background: LIMA/coronary steal syndrome is a rare but significant complication in patients with severe coronary artery disease (CAD) who have undergone coronary artery bypass grafting (CABG) and concurrently have high-flow arteriovenous (AV) fistulas for hemodialysis. The left internal mammary artery (LIMA) is a preferred conduit for CABG due to its long-term patency and ability to sustain myocardial perfusion. However, in patients with end-stage renal disease (ESRD) requiring hemodialysis, excessive AV fistula flow can divert blood away from the LIMA graft, leading to myocardial ischemia despite graft patency. Early recognition and appropriate intervention are essential to prevent further deterioration of cardiac function.

Original Publisher

HCA Healthcare Graduate Medical Education

Recommended Citation

Alsayed, Fahed; Badran, Muhannad; Khasawneh, Sara; and Sengodan, Mohan, "Case Report: Left Internal Mammary Artery (LIMA)/Coronary Steal Syndrome (CSS) in Severe Coronary Artery Disease and End-Stage Renal Disease" (2025). North Texas Research Forum 2025. 64.
https://scholarlycommons.hcahealthcare.com/northtexas2025/64