Singh Inder M, Subbarao Roopa A, Sadanandan Saihari
Vascular Interventions, Krannert Institute of Cardiology, Indiana University, MPC 2, Room D-4078, 1801 North Senate Blvd., Indianapolis, IN 46202-1258, USA.
J Invasive Cardiol. 2008 May;20(5):E161-6.
Symptomatic myocardial bridge is treated with medical therapy, but in refractory cases, percutaneous revascularization has been used. We describe two cases to highlight differences in coronary compression and flow pattern, which make the luminal narrowing associated with a myocardial bridge anatomically and physiologically different from the fixed stenosis of atherosclerotic epicardial disease. Due to these characteristics, evaluating the functional severity of a myocardial bridge using fractional flow reserve as a guide to revascularization may be of limited value. Furthermore, stenting, including drug-eluting stents, may not be the ideal revascularization strategy secondary to a higher risk of in-stent restenosis.
有症状的心肌桥采用药物治疗，但在难治性病例中，已采用经皮血管重建术。我们描述两例病例以突出冠状动脉压迫和血流模式的差异，这些差异使得与心肌桥相关的管腔狭窄在解剖学和生理学上不同于动脉粥样硬化性心外膜疾病的固定狭窄。由于这些特征，以血流储备分数作为血管重建术指导来评估心肌桥的功能严重程度可能价值有限。此外，包括药物洗脱支架在内的支架置入术可能并非理想的血管重建策略，因为支架内再狭窄风险较高。
