The aim of the study was the comparative analysis of the results of surgical and therapeutic management of symptomatic
patients (with systolic compression of tunnel segment > 50%) with isolated myocardial bridging of anterior interventricular
Material and methods. 104 patients under case follow-up were divided into two groups: group I (n=52) - patients
undergoing surgical treatment (coronary artery bypass grafting using left internal mammary artery in 30 patients and
great saphenous vein - 22 patients); group II (n=52) - patients undergoing therapeutic management. Preoperative
characteristics showed that patients with a higher grade of systolic compression of AIVA and higher functional class of
angina (p<0.05) prevailed in surgical group while female patients prevailed in therapeutic group.
Results. 1 patient from group I and 2 patients from group II died during the case follow-up period. Three-year survival
was 98% in both groups. There were 29 cases of hospital readmission (7 cases in surgical group and 22 - in therapeutic
group) (p=0.0132). Freedom from hospital readmission at 1 and 3 years was 93.75% and 84% in surgical group, and
80.7% and 62% in therapeutic group, respectively (p=0.08). Freedom from adverse outcomes at the same period was
93.75% and 84% in surgical group, and 79% and 60% in therapeutic group (p=0.056). Freedom from hospital readmission
in patients undergoing implantation of left internal mammary artery was 92%, great saphenous vein - 95% and
64% (p=0.227), respectively. Freedom from conduit dysfunction was 56% and 13% in patients with left internal mammary
artery and 82% (p=0.021) in patients with great saphenous vein, respectively.
Conclusion. Rates of hospital readmissions and adverse outcomes were higher in group of therapeutic treatment.
However they did not reach statistically significant difference. In view of high rates for such complications we recommend
the surgical intervention in symptomatic patients with MB of AIVA resistant to drug therapy and myocardial
ischemia confirmed by instrumental methods. The method of choice was the surgical intervention - coronary artery
bypass grafting using conduit from great saphenous vein.
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