”Novel” myocardial bridge surgery - article

Hello

for anyone interested and / or with a MB, I came across the article below which offers up a “novel” approach to CABG surgery for extensive bridges (greater than 5mm deep I interpreted that as).

this article suggests a bypass with the LIMA from the point of entry to the point of exit. There is a video too. so bypass only from point artery dips into the myocardium and then the point it comes out again. This is rather than bypassing the whole LAD. They call is a Myocardial Bridge Bypass Graft instead of a CAGB.

Unroofing (opening up the muscle layer above the buried artery to “release”) does not appear to be advisable for deep bridges but rather CABG (assuming the type widely performed) should be considered although these tend to fail / create competitive flow. Surgery for bridges is rare in UK apparently.

annalsthoracicsurgery.org/a...

LIMITATION - the article only talks about this having been done on one person and the outcome was only monitored at 3 months postoperative. But with all things MB there is little medium to long term evidence of the effectiveness of meds or surgery, not to mention a lack of understanding of symptomatic bridges amongst doctors.

BUT logic (or desperation / hope) makes me think there are so many UK surgeons who can do complex CABGs (and all the other complex heart surgeries) then it would it be reasonable to think that a “partial” bypass graft would not be beyond them?

Although being a Guinea Pig does not appeal, later in life with less responsibilities for others I’d probably think “go for it” (on basis a surgeon would have weighed up the risks and benefits anyway 😉).

You would think my cardiologist would know about a MBBG (myocardial bridge bypass graft)? Or does one have to be proactive and put it under their noses?

I’m waiting for a referral to a surgeon for decision on surgery although cardiologist said unlikely and risks outweigh benefits and probably still have symptoms even if they did surgery. Meds not worked.

I’m only sharing the article as I felt looked reasonably bone fide article.

😊

[Hidden]

😁 yes guess the heart is made up of motorways, a roads and b roads, just need a bypass then!

[Hidden]

uh anything that unblocks my LAD will be a civil engineering marvel! 😊

[Hidden]

thanks I will bring it up when get my chance to discuss, it sounds very plausible! good luck with tomorrow’s appointment! 👍

[Milkfairy Heart Star]

Interesting article.

Another thought, was the surgery performed at a well respected institution with a track record of good long term outcomes

Women are different, their hearts and blood vessels are smaller.

This is an example on a single male patient.

A doctor does have the professional responsibility of ' first do no harm' how will this affect their willingness to undertake such a procedure.

Before surgery in the UK a multidisciplinary team meets to make a collective decision about what are the best treatment options for a patient.

I always keep in mind the disaster of pelvic mesh surgery.

I really hope you can find the best treatment for your myocardial bridge. Living with unpredictable pain is not easy, I know!

I am now onto my 10th day of my latest hospital admission and counting....

You may have a perfect flow of blood through your rerouted blood supply however the cause of the chest pain could be due to coronary vasospasms.

Not an easy decision when there is so much uncertainty.

I have just sent you a PM with the names of 2 surgeons who maybe able to help.

[Hidden in reply to Milkfairy]

thanks for the different perspectives, and explaining the decision making process. the next stage is to properly discuss surgery even if answer is no. I should be used to the uncertainty but it’s the worst part of it all.

Then can move on with learning (from people like yourself who have first hand experience) how to live with the pain / live round it and in spite of it. 😊

[fishonabike]

Thank you for posting about this - i am not affected but I have shared it in another group where I know others have been diagnosed with this unusual condition - i hope it brings hope

I hope you find some relief soon

[Hidden in reply to fishonabike]

thanks, might helps someone😊