Catheter-based revascularization of the hepatic artery to treat coronary steal from a gastroepiploic artery bypass graft.

During diagnostic cardiac catheterization for symptoms of progressive angina, a high-grade ostial stenosis of an aberrant hepatic artery was identified. The common hepatic artery, which originated directly from the aorta rather than the celiac artery, supplied an in situ gastroepiploic artery bypass graft to the distal right coronary artery. Reduced flow within the bypass graft was observed consistent with a steal phenomenon from the coronary artery. This report describes successful angioplasty and stenting of the hepatic artery to salvage the gastroepiploic bypass graft and resolve the patient s ischemic symptoms.