外科治疗心肌桥19例分析△

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；埋人心肌冠状动脉长O．5-5cm；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。

Experience of surgical treatment of 19 patients with coronary myocardial bridge

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.