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Case reports

Off-pump supra-arterial myotomy for myocardial bridging

Division of Cardiac Surgery, Hospital de Cruces, Plaza de Cruces, Barakaldo 48903, Spain

Received 10 February 2008; accepted 31 March 2008.

^_* Corresponding author. Tel.: +34 946006339. (Email: ji.aramendi{at}terra.es).

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.

Key Words: Coronary artery disease • Ischemia • Off-pump • Revascularization