Sun Xiaoning, Chen Hao, Xia Limin, Zhao Dong, Ding Wenjun, Wang Chunsheng
Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
J Card Surg. 2012 Jul;27(4):405-7. doi: 10.1111/j.1540-8191.2012.01457.x. Epub 2012 May 20.
There is still controversy with regard to adequate therapy for symptomatic patients who are refractory to medical management with myocardial bridges of the left anterior descending artery. This study sought to evaluate the treatment of symptomatic coronary myocardial bridges with coronary artery bypass graft surgery.
Thirteen patients who underwent surgery between October 2005 and May 2008 were included in this study. The mean patient age was 51.3 ± 10.2 years (range, 39-75 years). There were ten men and three women. All 13 patients had angina pectoris preoperatively, and they had myocardial bridges only. Coronary angiography prior to surgery demonstrated myocardial bridging of the left anterior descending artery with systolic compression ≥75% in all patients. They underwent off-pump coronary artery bypass grafting using the internal mammary artery.
The acute clinical success rate was 100% with respect to the absence of myocardial infarction, death, or other major in-hospital complications. Postoperative coronary CT angiography studies in seven patients after one year demonstrated no graft stenosis. During follow-up, no patient had symptoms of angina.
Coronary artery bypass graft surgery using a LIMA graft is a safe and effective treatment for symptomatic coronary myocardial bridges.
对于左前降支心肌桥内科治疗无效的有症状患者，合适的治疗方法仍存在争议。本研究旨在评估冠状动脉搭桥手术治疗有症状冠状动脉心肌桥的疗效。
本研究纳入了2005年10月至2008年5月期间接受手术的13例患者。患者平均年龄为51.3±10.2岁（范围39 - 75岁）。男性10例，女性3例。所有13例患者术前均有胸痛症状，且仅患有心肌桥。术前冠状动脉造影显示所有患者左前降支心肌桥在收缩期受压≥75%。他们接受了使用乳内动脉的非体外循环冠状动脉搭桥术。
在无心肌梗死、死亡或其他主要院内并发症方面，急性临床成功率为100%。7例患者术后1年的冠状动脉CT血管造影研究显示无移植血管狭窄。随访期间，无患者出现胸痛症状。
使用左乳内动脉进行冠状动脉搭桥手术是治疗有症状冠状动脉心肌桥的一种安全有效的方法。
