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[Coronary stent placement for recurrent angina secondary to myocardial bridging]
1Unidad de Hemodinámica y Cardiología Intervencionista, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
Insights
Myocardial bridging, a coronary artery anomaly, can cause refractory angina. Stenting provided a successful treatment option for two patients with severe symptoms, restoring their exercise capacity.
Area of Science:
- Cardiology
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Myocardial bridging is a common coronary artery anomaly.
- Symptomatic patients typically respond to medical therapy, but refractory cases may require surgery.
- Surgical options include myotomy or coronary artery bypass grafting.
Observation:
- Two patients presented with recurrent angina due to long myocardial bridges in the mid-left anterior descending artery.
- Their symptoms were refractory to conventional medical treatments.
- Surgical intervention was considered but not initially performed.
Findings:
- Two consecutive coronary stents were successfully implanted in each patient.
- Both patients became asymptomatic following the stenting procedure.
- Follow-up at five and six months showed good exercise tolerance.
Implications:
- Coronary stenting can be an effective alternative treatment for selected patients with myocardial bridging and refractory angina.
- This approach may offer a less invasive option compared to surgical myotomy or bypass.
- Further research is warranted to establish stenting as a standard treatment for this condition.
Abstract:
Myocardial bridging of the epicardic coronary arteries is not an uncommon finding in angiographic or necropsic studies. Patients who have symptoms usually improve with medical treatment. However, in refractory patients a surgical myotomy of overlying myocardium and/or a coronary bypass may be needed. We report two patients with long myocardial bridges in the mid-left anterior descending coronary artery, who had recurrent angina refractory to conventional treatment. In both patients two consecutive coronary stents were successfully implanted. At five and six months follow-up they are asymptomatic and with good exercise tolerance.