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RF17 EARLY DIAGNOSIS AND SURGICAL TREATMENT OF MIOCARDIAL BRIDGES IN CHILDREN

Background and Aim: A myocardial bridge (MB) is a term for a segment of a coronary artery that takes a “tunneled” intramuscular course under a “bridge” of overlying myocardium. Although these congenital coronary anomalies can be asymptomatic and traditionally considered a benign condition with a good long-term prognosis, in many cases MBs are associated with heart rhythm disorder, myocardial infarction and sudden cardiac death, so that their impact on incidence of coronary insufficiency is indisputable. While described on autopsy for centuries, technological advances such as coronary computed tomography angiography and intravascular ultrasound have contributed greatly to our understanding of the anatomy, hemodynamic and pathophysiology. Surgical supra-arterial myotomy is the debridging procedure of choice to prevent myocardial infarction and sudden death in patients who remain symptomatic despite medical treatment. Method: We present our experience of 3 children (one 10 years old and other two 14 years old) with myocardial bridges who underwent surgical treatment. The diagnostic and operative techniques for each patient were evaluated. Mean follow up 1 year. Results: All patients underwent successful debridging through surgical supra-arterial myotomy on extracorporeal circuit and cardioplegic cardiac arrest. No early or late complications except a post-pericardiotomy syndrome in one patient resolved with medical treatment. At last follow up all patients are asymptomatic Conclusion: Based on our experience, early diagnosis and surgical intervention can yield satisfactory results in patients with myocardial bridges, with relief of symptoms. The operative procedures were associated with no early and late mortality and low complications.