Myocardial Bridge in Children: Do we care about it?

Objective: Myocardial bridges are congenital anomalies known to cause adverse events in adults. However, this anomaly is less often considered a differential diagnosis in the evaluation of children with chest pain. Anomalous aortic origin of a coronary artery (AAOCA) is being identified with increasing frequency, and myocardial bridges have been found intraoperatively. Myocardial bridges, being congenital, have the potential to affect children.

Methods: This was a retrospective review of 38 patients who underwent surgical unroofing of myocardial bridges in isolation or as part of AAOCA repair at a single institution. We share our diagnostic approach and surgical strategy for this disease.

Results: 14 patients underwent surgical unroofing for isolated myocardial bridges and 21 as an additional procedure at the time of coronary unroofing or reimplantation for AAOCA. Three patients underwent AAOCA surgery, and recurrent angina prompted evaluation for a myocardial bridge.

Conclusions: Myocardial bridges are common and can be symptomatic in children. It should be considered as a differential diagnosis in children presenting with undiagnosed chest pain. It is easy to identify with current investigative modalities, and surgical treatment is effective in hemodynamically significant lesions.