Introduction
For the same case, Shuichiro Yamauchi, a cardiologist at our hospital,
has published a previous paper on the usefulness of perioperative
coronary angiography (CAG) and fractional flow reserve (FFR) using
high-dose dobutamine infusion as a diagnosis of myocardial bridge (MB)
[1]. Surgical techniques are also very useful, so I would like to
report this case focusing on surgical techniques.
In MB, the muscular bridge results in systolic compression of the
tunneled portion of the coronary artery and infrequently causes
myocardial ischemia and sudden death [2]. As a surgical method of
MB, coronary artery bypass grafting (CABG) is reported to be most
beneficial in long or deep MB. In the absence of long or deep bridges,
surgical unroofing of the overlying muscle fibers is an effective
option. Unroofing is generally performed under cardio-pulmonary bypass
support or cardioplegic arrest [3]. Though minimally invasive
approach is beneficial for patients with MB, there is a limited number
of reports.
Herein, we present a case of minimally invasive off-pump unroofing via
left mini-thoracotomy for MB of the left anterior descending coronary
artery (LAD). We had written consent from the patient about this case
report. IRB number is B202112-01 and date of approval is 12/23/2021.