Off-pump supra-arterial myotomy for myocardial bridging

• Published in: European journal of cardio-thoracic surgery Vol. 34; no. 3; pp. 682 - 684
• Main Authors: Crespo, Alejandro, Aramendi, José I., Hamzeh, Gadah, Voces, Roberto
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Science B.V 01.09.2008; Elsevier Science
• Subjects: Angina Pectoris - etiology; Biological and medical sciences; Cardiology. Vascular system; Cardiopulmonary Bypass; Coronary Angiography; Coronary Artery Bypass, Off-Pump; Coronary artery disease; Coronary heart disease; Female; Heart; Humans; Ischemia; Male; Medical sciences; Middle Aged; Myocardial Bridging - complications; Myocardial Bridging - diagnostic imaging; Myocardial Bridging - surgery; Off-pump; Pneumology; Revascularization; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart; Treatment Outcome; Off-pump; Ischemia; Coronary artery disease; Revascularization; Myotomy; Cardiovascular disease; Coronary heart disease; Artery; Pump; Treatment; Bridging; Surgery; Myocardium; Circulatory system; Cardiology; Pneumology
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/j.ejcts.2008.03.073

We report the results of surgery and midterm outcome in two patients with symptomatic myocardial bridging who underwent off-pump supra-arterial myotomy. Both patients were operated upon through a median sternotomy. The anterior wall of the heart was exposed in the same manner as in off-pump CABG. The left anterior descending coronary artery is unroofed from its myocardial bridge with the aid of a heart stabilizer and a blower. Neither heparin nor blood transfusion was required. Both patients survived the operation and are asymptomatic. Postoperative coronary angiogram showed good resolution of the muscle bridge in one patient. We conclude that in symptomatic patients with myocardial bridging despite medical therapy, surgical myotomy can be considered an adequate therapy. It can be safely done off-pump.