Influence of moderate left subclavian artery stenosis on outcomes after coronary bypass surgery in patients requiring hemodialysis

Objectives: Left subclavian artery stenosis in patients requiring hemodialysis can cause coronary steal syndrome via the left internal thoracic artery (LITA) graft to the left anterior descending artery (LAD), potentially leading to graft failure. This study evaluated the influence of moderate left subclavian artery stenosis on long-term outcomes following LITA-LAD coronary artery bypass grafting. Methods: Among 1744 patients undergoing primary isolated coronary artery bypass grafting, 104 patients requiring hemodialysis with left upper limb arteriovenous fistulas and preoperative contrast-enhanced computed tomography were analyzed. Left subclavian artery stenosis was quantified as: (1-minimal lumen area/reference lumen area) × 100. Patients were grouped by stenosis severity: ≥50% (n = 25) versus