Introduction
Myocardial bridging (MB) occurs when a band of cardiac muscle overlies
the intramural segment of the coronary artery, resulting in systolic
compression that is observable on coronary
angiography.1 MB is a well-recognized phenomenon that
has 1–3% prevalence in the general population. Its clinical
presentation ranges from no symptoms to chest pain, myocardial
infarction (MI), and even sudden death.2 MB is more
notably prevalent among patients with hypertrophic cardiomyopathy (HCM),
with a prevalence of up to 30%.3 Previous studies
have reported that in pediatric patients with HCM, the presence of MB is
associated with disease severity.4,5 However, for
patients with hypertrophic
obstructive cardiomyopathy (HOCM) requiring surgery, whether and how MB
should be treated remain unclear.
To date, there are no
recommendations or guidelines regarding the optimal management of MB in
patients with HOCM. The existing surgical treatments of MB mainly
include coronary artery bypass grafting (CABG) and unroofing, which
involves the use of a saphenous vein graft (SVG) and the left internal
mammary artery (LIMA).6 However, it has not been
established which between CABG and unroofing is better. Therefore, in
this study, we evaluated the midterm outcomes of these different
treatment methods in patients with HOCM complicated with MB.