外科治疗心肌桥19例分析

Experience of surgical treatment of 19 patients with coronary myocardial bridge

目的总结19例心肌桥患者的外科治疗经验。方法2006年1月至2011年4月广东省人民医院共收治心肌桥患者19例,男11例,女8例,年龄(53.4±13.9)岁。4例单纯性心肌桥,15例合并有其他心脏疾病。19例均为左冠状动脉前降支心肌桥,近段6例,中段8例,远段5例;埋入心肌冠状动脉长0.5～5 cm;收缩期冠状动脉管腔狭窄40%～95%。15例在体外循环下行心肌桥松解术,4例在非体外循环下松解,合并的其他心脏畸形给予同期矫治。结果全组无死亡及术后并发症的发生,随访4个月～5年,均无不适症状。结论外科治疗心肌桥是安全和有效的,不能药物治疗和造成冠状动脉严重狭窄的心肌桥可考虑手术治疗。

Objectives To summarize the experence of the surgical treatment of coronary myocardial bridge. Methods Nineteen patients （11 male , 8 female）, aged （53.4±13.9） years, underwent surgical treatment in Guangdong General Hospital From January 2006 to April 2011 were included in this study. There were 4 cases with isolated myocardial bridge, 15 cases complicated with other coronary artery heart diseases. All the myocardial bridge of 19 patients happened in left anterior descending, 6 cases of which with proximal segments, 8 cases with middle segments, and 5 cases with distal segments. The length of the myocardial bridge varied from 0.5 to 5.0 cm, and the systolic coronary artery stenosis varied from 40% to 95%. Fifteen eases were under cardiopulmonary bypass, and others under off-pump. Results All patients survived and recovered uneventfully. Neither hospital or late death nor major complications occurred in the follow-up （4 months to 5 years）. Conclusions The surgical treatment of coronary myocardial bridge is safe and satisfing. The patients who are refractory to medication should actively undergo the surgical procedures.