{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T10:42:33Z","timestamp":1776681753596,"version":"3.51.2"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Myocardial bridging (MB) is a congenital coronary artery disease. Surgical interventions are indicated if angina persists after optimization of medical treatments. Coronary artery bypass grafting (CABG) is one of the surgical options for MB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 66-year-old male experienced exertional angina for 10 months. Treadmill test revealed ischaemic change during exercise. Coronary angiography revealed myocardial bridging in middle part of the left anterior descending artery (LAD) with prominent squeezing during systolic phase. Medical control was advised. However, symptoms persisted after maximally tolerated non-dihydropyridine calcium channel blockers and beta-adrenergic antagonists. After discussing with the heart team, the patient underwent CABG with left internal mammalian artery canalized to distal LAD. The surgeon chose CABG due to the concern of ventricular rupture after myotomy for long MB. Nevertheless, angina recurred and persisted several months after CABG. Follow-up coronary angiography delineated to-and-fro retrograde blood flow in graft without actual feeding flow into the distal LAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case demonstrates that coronary artery bypass grafting may not be an appropriate therapeutic strategy for patients with isolated myocardial bridging. Comprehensive preoperative evaluation, including stress testing and invasive haemodynamic assessment, is crucial before considering CABG. Optimization of medical therapy for myocardial bridging\u2013related symptoms should be thoroughly pursued prior to surgical intervention and should include beta-adrenergic blockers, non-dihydropyridine calcium channel blockers, ranolazine, and ivabradine. Nitrates should be avoided in patients with myocardial bridging. For patients with isolated myocardial bridging and refractory angina despite optimal medical therapy, surgical unroofing may represent a more favourable option than CABG.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag251","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T11:42:55Z","timestamp":1775648575000},"source":"Crossref","is-referenced-by-count":0,"title":["Coronary artery bypass grafting may not be suitable in pure myocardial bridging: a case report"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2073-3407","authenticated-orcid":false,"given":"Tsung-Lin","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University , No. 250, Wuxing Street, Xinyi District, Taipei City 110 ,","place":["Taiwan"]},{"name":"Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital , No. 252, Wuxing Street, Xinyi District, Taipei City 110 ,","place":["Taiwan"]},{"name":"Taipei Heart Institute, Taipei Medical University , No. 250, Wuxing Street, Xinyi District, Taipei City 110 ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3772-1704","authenticated-orcid":false,"given":"Chuan-Chih","family":"Hsu","sequence":"additional","affiliation":[{"name":"Taipei Heart Institute, Taipei Medical University , No. 250, Wuxing Street, Xinyi District, Taipei City 110 ,","place":["Taiwan"]},{"name":"Division of Cardiovascular Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, No. 250, Wuxing Street, Xinyi District, Taipei City 110 ,","place":["Taiwan"]},{"name":"Division of Cardiovascular Surgery, Department of Surgery, Taipei Medical University Hospital , No. 252, Wuxing Street, Xinyi District, Taipei City 110 ,","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"2026042005411036300_ytag251-B1","doi-asserted-by":"crossref","first-page":"2196","DOI":"10.1016\/j.jacc.2021.09.859","article-title":"Myocardial bridging: diagnosis, functional assessment, and management: JACC state-of-the-art review","volume":"78","author":"Sternheim","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2026042005411036300_ytag251-B2","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1111\/1556-4029.13665","article-title":"Myocardial bridging: a meta-analysis of prevalence","volume":"63","author":"Hostiuc","year":"2018","journal-title":"J Forensic Sci"},{"key":"2026042005411036300_ytag251-B3","doi-asserted-by":"crossref","first-page":"758","DOI":"10.2459\/JCM.0000000000000551","article-title":"What is the optimal treatment for symptomatic patients with isolated coronary myocardial bridge? 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