Immediate results of treatment of patients with myocardial bridges of the coronary arteries
I. K. Ismail-zade,
V. K. Grebennik,
I. I. Ivanov,
N. R. Abutalimova,
D. G. Zavarzina,
G I. Ishmukhametov,
M. L. Gordeev https://doi.org/10.24884/0042-4625-2021-180-1-17-24
Abstract
The objective was to evaluate the immediate results of treatment of patients with symptomatic form of myocardial bridges of the coronary arteries.
Methods and materials. In the course of a retrospective study, the results of treatment of 70 patients who had underwent drug treatment and 52 patients who had underwent surgical treatment were analyzed. All the subjects had high functional angina pectoris.
Results. Pharmacological therapy showed significant positive dynamics in 18 (25.7 %) patients. Analysis of the intraoperative and early postoperative periods in patients who underwent supracoronary myotomy allows us to conclude that surgical treatment of patients with myocardial bridges of the coronary arteries shows satisfactory results.
Conclusion. Drug therapy may be effective in some patients with myocardial bridges of the coronary arteries. In case of ineffectiveness of pharmacological treatment, the possibility of performing surgery in the amount of supracoronary myotomy should be considered.
About the Authors
I. K. Ismail-zade
Almazov National Medical Research Centre
Russian Federation
Competing Interests:
Russian Federation
Ismail-zade Imran K. - Postgraduate Student, Cardiovascular Surgeon.
2, Akkuratova str., Saint Petersburg, 197341
Competing Interests:
no conflict of interest
V. K. Grebennik
Almazov National Medical Research Centre
Russian Federation
Competing Interests:
Russian Federation
Grebennik Vadim K. - Cardiovascular Surgeon, Head of the Department.
Saint Petersburg
Competing Interests:
no conflict of interest
I. I. Ivanov
Almazov National Medical Research Centre
Russian Federation
Competing Interests:
Russian Federation
Ivanov Ivan Yu. - Resident of the Department of Cardiovascular Surgery.
Saint Petersburg
Competing Interests:
no conflict of interest
N. R. Abutalimova
Almazov National Medical Research Centre
Russian Federation
Competing Interests:
Russian Federation
Abutalimova Napisat R. – Intensivist.
Saint Petersburg
Competing Interests:
no conflict of interest
D. G. Zavarzina
Almazov National Medical Research Centre
Russian Federation
Competing Interests:
Russian Federation
Zavarzina Daria G. - Resident of the Department of Cardiovascular Surgery.
Saint Petersburg
Competing Interests:
no conflict of interest
G I. Ishmukhametov
Almazov National Medical Research Centre
Russian Federation
Competing Interests:
Russian Federation
Ishmukhametov Gleb I. - Resident of the Department of Cardiovascular Surgery.
Saint Petersburg
Competing Interests:
no conflict of interest
M. L. Gordeev
Almazov National Medical Research Centre
Russian Federation
Competing Interests:
Russian Federation
Gordeev Mikhail L. - Dr. of Sci. (Med.), Professor, Head of the Unit, Head of the Department, Chief Cardiac Surgeon of the Center.
Saint Petersburg
Competing Interests:
no conflict of interest
References
1. Portsmann W., Iwig J. Die intramurale koronaroarterie im angiogramm // Fortschr Roentenstr. 1960;(92):129.
2. Erbel R., Ge J., Möhlenkamp S. Myocardial bridging: a congenital variant as an anatomic risk factor for myocardial infarction // Circulation. 2009;120(5):357–359. Doi: 10.1161/CIRCULATIONAHA.109.881367
3. Arjomand H., AlSalman J., Azain J., Amin D. Myocardial bridging of left circumflex coronary artery associated with acute myocardial infarction // J Invasive Cardiol. 2000;12(8): 431–434. PMID: 10953110.
4. Amitani K., Yamaguchi T., Takahashi N., Uchida T., Kushikata Y., Munakata K. et al. Two cases of myocardial bridge associated with myocardial ischemia [Japanese] // J Nippon Med Sch 2000;(67):206–209. Doi: 10.1272/jnms.67.206.
5. Schar B. Myocardial bridging: symptoms of coronary disease that sometimes is not // Schweiz Rundsch Med Prax 2001;(90):1923–1928. Doi: 10.1055/s-0031-1278262.
6. Akdemir R., Gunduz H., Emiroglu Y., Uyan C. Myocardial bridging as a cause of acute myocardial infarction: a case report. // BMC Cardiovasc Disord. 2002;(2):15. Doi: 10.1186/1471-2261-2-15.
7. Angelini P., Velasco J. A., Flamm S. Coronary anomalies: incidence, pathophysiology, and clinical relevance // Circulation. 2002;105(20):2449–2454. Doi: 10.1161/01.cir.0000016175.49835.57.
8. Stables R. H., Knight C. J., McNeill J. G. et al. Coronary stenting in the management of myocardial ischemia caused by muscle bridging // Br Heart J. 1995;(74):90–92.
9. Möhlenkamp S., Hort W., Ge J., Erbel R. Update on myocardial bridging // Circulation. 2002;106(20):2616–2622. Doi: 10.1161/01.cir.0000038420.14867.7a
10. Konen E., Goitein O., Sternik L., Eshet Y., Shemesh J., Di Segni E. et al. The prevalence and anatomical patterns of intramuscular coronary arteries: a coronary computed tomography angiographic study // J Am Coll Cardiol. 2007;49(5):587–593. Doi: 10.1016/j.jacc.2006.09.039.
11. La Grutta L., Runza G., Lo Re G., Galia M., Alaimo V., Grassedonio E. et al. Prevalence of myocardial bridging and correlation with coronary atherosclerosis studied with 64-slice CT coronary angiography // Radiol Med. 2009;114(7):1024–1036. Doi: 10.1007/s11547-009-0446-y.
12. Ge J., Jeremias A., Rupp A., Abels M., Baumgart D., Liu F. et al. New signs characteristic of myocardial bridging demonstrated by intracoronary ultrasound and Doppler // Eur Heart J. 1999;20(23):1707–1716. Doi: 10.1053/euhj.1999.1661.
13. Schwarz E. R, Klues H. G, vom Dahl J., Klein I., Krebs W., Hanrath P. et al. Functional characteristics of myocardial bridging. A combined angiographic and intracoronary Doppler flow study // Eur Heart J. 1997; 18(3):434–442. Doi: 10.1093/oxfordjournals.eurheartj.a015263.
14. Escaned J., Cortés J., Flores A., Goicolea J., Alfonso F., Hernández R. et al. Importance of diastolic fractional flow reserve and dobutamine challenge in physiologic assessment of myocardial bridging // J Am Coll Cardiol. 2003;42(2):226–233. Doi: 10.1016/s0735-1097(03)00588-6.
15. Gawor R., Kuśmierek J., Płachcińska A., Bieńkiewicz M., Drożdż J., Piotrowski G. et al. Myocardial perfusion GSPECT imaging in patients with myocardial bridging // J Nucl Cardiol. 2011;18(6):1059–1065. Doi: 10.1007/s12350-011-9406-8.
16. Berry J. F, von Mering G. O, Schmalfuss C., Hill J. A, Kerensky R. A. Systolic compression of the left anterior descending coronary artery: a case series, review of the literature, and therapeutic options including stenting // Catheter Cardiovasc Interv. 2002;56(1):58–63. Doi: 10.1002/ccd.10151.
17. Rossi L., Dander B., Nidasio G. P. et al. Myocardial bridges and ischemic heart disease. Eur Heart J. 1980;1(4):239–245. Doi: 10.1093/oxfordjournals.eurheartj.a061125.
18. Shin Lin, Jennifer A., Tremmel, Ryotaro Yamada, Ian S. Rogers, Celina Mei Yong, Robert Turcott et al. A novel stress echocardiography pattern for myocardial bridge with invasive structural and hemodynamic correlation // J Am Heart Assoc. 2013;2(2):000097. Doi: 10.1161/JAHA.113.000097.
19. Gowda R. M, Khan I. A, Ansari A. W, Cohen R. A. Acute ST segment elevation myocardial infarction from myocardial bridging of left anterior descending coronary artery // Int J Cardiol. 2003;90(1):117–118. Doi: 10.1016/s0167-5273(02)00518-1.
20. Pratt J. W, Michler R. E, Pala J., Brown D. A. Minimally invasive coronary artery bypass grafting for myocardial muscle bridging // Heart Surg Forum. 1999;(2:250–253.
21. Wu Q. Y., Xu Z. H. Surgical treatment of myocardial bridging: report of 31 cases // Chin Med J. 2007;(120):1689–1681.
22. Wan L., Wu Q. Myocardial bridge, surgery, or stenting? // Interact Cardiovasc Thorac Surg. 2005;(4):517–520.
23. Kracoff O. H., Ovsyshcher I., Gueron M. Malignant course of a benign anomaly: myocardial bridging. Chest. 1987;92(6):1113–1115. Doi: 10.1378/chest.92.6.1113.
24. Roul G., Sens P., Germain P., Bareiss P. Myocardial bridging as a cause of acute transient left heart dysfunction // Chest. 1999;116(2):574–580. Doi: 10.1378/chest.116.2.574.
25. Feld H., Guadanino V., Hollander G., Greengart A., Lichstein E., Shani J. Exercise-induced ventricular tachycardia in association with a myocardial bridge // Chest. 1991;99(5):1295–1296. Doi: 10.1378/chest.99.5.1295.
26. Tio Loukas M., Curry B., Bowers M. et al. The relationship of myocardial bridges to coronary artery dominance in the adult human heart // J Anat. 2006;(209):43–50.
27. Attaran S., Moscarelli M., Athanasiou T., Anderson J. Is coronary artery bypass grafting an acceptable alternative to myotomy for the treatment of myocardial bridging? // Interact Cardiovasc Thorac Surg. 2013; (16):347–349.
28. Huang X. H., Wang S. Y., Xu J. P. et al. Surgical outcome and clinical follow-up in patients with symptomatic myocardial bridging // Chin Med J (Engl). 2007;(120):1563–15966.
29. Bockeria L. A., Sukhanov S. G., Orekhova E. N., Shatakhyan M. P., Korotayev D. A., Sternik L. Results of coronary artery bypass grafting in myocardial bridging of left anterior descending artery // J Card Surg. 2013;(28):218–221. Doi: 10.1111/jocs.12101.
Supplementary files
Review
For citations:
Ismail-zade I.K., Grebennik V.K., Ivanov I.I., Abutalimova N.R., Zavarzina D.G., Ishmukhametov G.I., Gordeev M.L. Immediate results of treatment of patients with myocardial bridges of the coronary arteries. Grekov's Bulletin of Surgery. 2021;180(1):17-24. (In Russ.) https://doi.org/10.24884/0042-4625-2021-180-1-17-24
Views:
684
Email this article 