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Published on: June 28, 2019
Normalisation of abnormal coronary fractional flow reserve associated with myocardial bridging using an intracoronary
B D Prendergast1, F Kerr, I R Starkey
1Department of Cardiology, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK.
Insights
Intracoronary stenting effectively treats myocardial bridging by resolving both physical blockages and impaired blood flow. This case study demonstrates stenting normalizes coronary fractional flow reserve, confirming its physiological benefit.
Area of Science:
- Cardiovascular medicine
- Interventional cardiology
- Physiology
Background:
- Myocardial bridging is a congenital anomaly where a segment of a coronary artery tunnels through heart muscle.
- Intracoronary stenting is a proposed treatment, but its physiological impact is not well understood.
Observation:
- A 70-year-old male presented with symptoms of cardiac ischemia.
- The patient had a myocardial bridge in the left anterior descending coronary artery.
Findings:
- Intracoronary stenting eliminated the visible abnormalities of the coronary artery bridge on angiography.
- Stenting also corrected significant abnormalities in coronary fractional flow reserve.
Implications:
- This study provides physiological evidence supporting intracoronary stenting for myocardial bridging.
- Stenting may be a viable option to restore normal coronary hemodynamics in affected patients.
Abstract:
Although intracoronary stenting procedures have been advocated for the successful treatment of myocardial ischaemia associated with myocardial bridging, the physiological rationale for this approach remains unexplored. The case of a 70 year old man with symptoms of cardiac ischaemia associated with a left anterior descending coronary artery bridge is described, where use of an intracoronary stent abolished the angiographic abnormalities and also restituted pronounced abnormalities of coronary fractional flow reserve.
