Coronary Steal Syndrome due to a Side Branch of the LIMA in Patients Undergoing Coronary Artery Bypass Grafting

Coronary steal syndrome (CSS) is a rare but potentially serious phenomenon that can occur after coronary artery bypass grafting (CABG), where the presence of a patent large collateral arterial branch may decrease flow through the main graft toward the myocardium. This condition can result in functional incomplete revascularization and reduce the benefit of the surgical intervention. The diagnosis and management of CSS pose significant challenges, which are described in this article through three clinical cases, accompanied by a review of existent medical data regarding this rare pathology.