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Myocardial bridge, surgery or stenting?

Li Wan1, Qingyu Wu

  • 1Department of Cardiovascular Surgery, Cardiovascular Institute, Fu Wai Hospital, Chinese Academy of Medical Science, Peking Union Medical College, 167 Bei Li Shi Road, Fuchengmenwai, Beijing, China. wlzh7580@yahoo.com.cn

Interactive Cardiovascular and Thoracic Surgery
|August 3, 2007
PubMed

Insights

Surgical treatment for myocardial bridge (MB) showed excellent outcomes with no late complications. Stent implantation for MB resulted in restenosis and recurrent angina, suggesting surgery is a superior option.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery

Background:

  • Myocardial bridge (MB) is a congenital heart anomaly where a segment of a coronary artery travels through the heart muscle.
  • Surgical and interventional treatment options for symptomatic MB have evolved, necessitating a review of clinical outcomes.

Purpose of the Study:

  • To compare the clinical experience and long-term outcomes of surgical treatment versus stent implantation for myocardial bridge.
  • To evaluate the efficacy and safety of different treatment modalities for MB.

Main Methods:

  • A retrospective review of 15 patients who underwent surgical treatment (coronary artery bypass grafting or myotomy) for MB.
  • Analysis of 4 patients who received stent implantation for MB.
  • Follow-up assessment of clinical outcomes, including mortality, readmission, and angina recurrence.

Main Results:

  • All surgical patients survived and recovered uneventfully, with no late deaths, readmissions, or angina.
  • Stent implantation patients had excellent initial angiographic results, but two experienced angina recurrence due to intimal proliferation and systolic compression.
  • Surgical treatment demonstrated excellent early and late results.

Conclusions:

  • Surgical intervention for myocardial bridge offers superior long-term outcomes compared to stent implantation.
  • Myotomy and coronary artery bypass grafting are effective and safe surgical options for managing symptomatic myocardial bridge.

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