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.