Abstract:

Objective To analyse the clinical features and outcomes of myocardial bridge treated by coronary artery bypass grafting (CABG). Methods The hospitalization and follow-up data of patients with myocardial bridge treated between March 1999 and March 2009 were collected. The symptoms, examinations, diagnosis, treatment and follow-up findings were retrospectively analysed, the clinical features and outcomes were analysed, and discussion was performed after literature review. Results Twenty-six patients with myocardial bridge were hospitalized, all of whom were confirmed by coronary angiography. All patients experienced symptoms of myocardial ischemia such as angina, which could not be relieved by medication. Electrocardiography was characterized by depressed ST, flat or inversed T wave. All patients received CABG(off-pump operation in 15 patients and on-pump operation in 11 patients). No surgery-related death or complications occurred. Patients were followed up for (3.5±2.0) years, and symptom of myocardial ischemia was relieved in all. Angina took place in 5 patients, and was eased by medication. Electrocardiographic reexaminations revealed that ST was normal in 22 patients, and flat ST was improved in the other 4 patients after operation. Conclusion Myocardial bridge is one of the congenital coronary artery malformations, and was mainly diagnosed through coronary arteriography examination. CABG is one of the best choices for the treatment of myocardial bridge with severe myocardial ischemia. Angina after operation in some patients may be related to the vascular spasm, as well as the blood flow competition between own vessels and grafts.

Key words: myocardial bridge, coronary artery bypass grafting, ischemia, angina, coronary angiography