Minimally Invasive Coronary Artery Bypass Grafting for Myocardial Muscle Bridging

(#1999-9646 ... May 21, 1999)

Jerry W. Pratt, MD, Robert E. Michler, MD, Jawahar Pala, MD, and David A. Brown, MD

Division of Cardiothoracic Surgery and Division of Cardiology, The Ohio State University, Columbus, Ohio

ABSTRACT

Myocardial bridging is a congenital anomaly of the left anterior descending coronary artery (LAD), which is associated with myocardial ischemia and infarction, cardiac arrhythmias, and sudden cardiac death. Two cases are reported of symptomatic myocardial bridging refractory to medical management treated by minimally invasive coronary artery bypass grafting without cardiopulmonary bypass. We conclude that minimally invasive coronary artery bypass techniques are appropriate alternatives to endovascular stent placement, muscle bridge division, or aortocoronary grafting with cardiopulmonary bypass for the management of symptomatic myocardial bridging.

AUTHOR/ARTICLE INFORMATION

Acknowledgment: The opinions and conclusions in this paper are those of the authors and are not intended to represent the official position of the Department of Defense, United States Air Force, or any other government agency. We would like to thank Kelly Knott for her assistance with the preparation of this manuscript.

Presented at the Second Annual Meeting of the International Society for Minimally Invasive Cardiac Surgery, Palais dés Congres, Paris, France, May 21-22, 1999.

Reprint requests to: David A. Brown, MD, Division of Cardiothoracic Surgery, The Ohio State University, N825 Doan Hall, 410 W. 10th Ave.,Columbus, OH, USA 43210-1228; E-Mail: brown-4@medctr.osu.edu; PH: (614) 293-4558; Fax: (614) 293-4726

Submitted on: Peer reviewed and accepted at the International Society for Minimally Invasive Cardiac Surgery's 2nd Annual Meeting and Scientific Sessions, Paris, France, May 21-22 1999.

Keywords: Myocardial bridging, minimally invasive coronary artery bypass grafting (MIDCAB), myocardial ischemia