Surgical unroofing of hemodynamically significant myocardial bridges in a pediatric population

The Journal of Thoracic and Cardiovascular Surgery
Katsuhide MaedaIan S Rogers

Abstract

Although myocardial bridges (MBs) are traditionally regarded as incidental findings, it has been reported that adult patients with symptomatic MBs refractory to medical therapy benefit from unroofing. However, there is limited literature in the pediatric population. The aim of our study was to evaluate the indications and outcomes for unroofing in pediatric patients. We retrospectively reviewed all pediatric patients with MB in our institution who underwent surgical relief. Clinical characteristics, relevant diagnostic data, intraoperative findings, and postoperative outcomes were evaluated. Between 2012 and 2016, 14 pediatric patients underwent surgical unroofing of left anterior descending artery MBs. Thirteen patients had anginal symptoms refractory to medical therapy, and 1 patient was asymptomatic until experiencing aborted sudden cardiac arrest during exercise. Thirteen patients underwent exercise stress echocardiography, all of which showed mid-septal dys-synergy. Coronary computed tomography imaging confirmed the presence of MBs in all patients. Intravascular ultrasound imaging confirmed the length of MBs: 28.2 ± 16.3 mm, halo thickness: 0.59 ± 0.24 mm, and compression of left anterior descending artery at resting heart...Continue Reading

Citations

Aug 11, 2020·World Journal for Pediatric & Congenital Heart Surgery·Sameh M SaidGurumurthy M Hiremath
May 10, 2019·Clinical Medicine Insights. Cardiology·Hiroki TeragawaTomohiro Ueda
May 21, 2021·The Journal of International Medical Research·Francesco BiancoSabina Gallina
Jun 12, 2021·Paediatrics and International Child Health·Federica BrancatoGabriella De Rosa
Jan 23, 2021·The Annals of Thoracic Surgery·Jin-Zhou ZhangZhen Wang
Dec 18, 2020·The Annals of Thoracic Surgery·Hanjay WangJack H Boyd

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