Abstract:
Introduction. Complete myocardial bridges (CMB) are myocardial strips covering a portion of
the underepicardial coronary artery on one or more of its parts. Thick myocardial bridges are
considered to have a specific role in heart emergencies occurrence: the myocardial infarction and
sudden death in young people with clean coronary vessels after physical exercises.
Aim of the study. To distinguish different anatomical features of CMB and their possible
involvement in the ischemic heart disease. Material and methods. 300 formalized human hearts were studied by fine anatomical dissection
method at macroscopic, macro-microscopic (stained with Schiff reagent) and microscopic
(stained with hematoxylin-eosin and pycrofuxin by van Gieson method) levels.
Results. CMB were found in 62.5% cases. Most frequently CMB cover the anterior
interventricular branch, followed by the diagonal branches of both ventricles, first marginal
branch and posterior interventricular branch. The width of about 1/3 of complete myocardial
bridges (34%) was about 10-19 mm, in 25% of cases its width was 20-29 mm, in 18% of
dissected hearts the width of CMB was 1-9 mm and only in 4% of cases wide bridges, up to 70
mm, were found on anterior interventricular branch. Macro-microscopic and microscopic study
revealed deformation and narrowing of the vessel under the bridge what could have an important
role in heart ischemic sufferings and sudden death. Microscopic investigation of the under-bridge
segment indicates that the direction of the myocardial fibers varies. While in thin myocardial
bridges the direction of the myocardial fibers is similar to the first myocardial layer, in thick
bridges, especially those located above the anterior interventricular branch, myocardial fibers
surround the vessel and have the helicoidally orientation, forming a myocardial tunnel around
the vessel.
Description:
Medpark International Hospital, Cardiology and Interventional Cardiology Department, Cardiac
Surgery Department,
Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova