Myotomy through heart-port access for myocardial bridging

We report a case of a 21-year-old man with a myocardial bridging of the left anterior descendens coronary artery associated with a regional systolic dysfunction of the left ventricle. Continuously elevated troponin levels suggested the presence of myocardial ischemia. Because of a tendency of worsening left ventricular systolic function, this myocardial bridge was treated by myotomy. Sternotomy could be avoided by doing the procedure with a heart-port access. The pathophysiology of myocardial bridging is incompletely understood. It is sometimes associated with overt pathology, as well as it can just be an incidental finding without any significance.