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Myotomy for myocardial bridge utilizing harmonic scalpel.
Bryan A Miles1, Joseph A Lahorra1
1Department of Cardiothoracic Surgery, Cleveland Clinic Akron General, Akron, USA.
International Journal of Surgery Case Reports
|September 11, 2023
Summary
Myocardial bridge, a condition where coronary arteries run through heart muscle, can cause severe chest pain. Surgical myotomy using a harmonic scalpel offers a safe and effective treatment, relieving symptoms and improving operative outcomes.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
Background:
- Myocardial bridge involves epicardial coronary arteries passing through the myocardium, potentially causing angina.
- While often asymptomatic, myocardial bridges can lead to severe chest pain, necessitating intervention when medical management fails.
Observation:
- A 50-year-old male patient with a myocardial bridge refractory to medical treatment was successfully managed.
- The patient underwent myotomy using a harmonic scalpel, experiencing complete relief from exertional chest pain.
Findings:
- Harmonic scalpel myotomy provides superior hemostasis and protects the left anterior descending artery and heart cavity.
- This technique offers improved operative efficiency compared to traditional sharp or electrocautery methods.
Implications:
- Harmonic scalpel myotomy presents significant intra-operative advantages for myocardial bridge treatment.
- Further long-term studies are needed to compare the efficacy of different myotomy techniques.
