Cardiac CT scan for preoperative planning in a patient with bilateral subclavian stenosis needing coronary artery bypass.

A 61-year-old male vasculopath presented for coronary revascularization and was found to have high-grade bilateral subclavian artery stenosis. The adequacy of the left internal mammary artery for bypass to the left anterior descending artery was in question. Rather than assessing the left internal mammary artery intraoperatively, we performed a preoperative cardiac computed tomography (CT) angiogram. This showed that the free left internal mammary artery was a suitable conduit and the procedure was performed expeditiously. Therefore, cardiac CT angiography is a noninvasive tool for preoperative planning in coronary revascularization.