{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T14:59:27Z","timestamp":1781362767825,"version":"3.54.1"},"reference-count":20,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Innovations\ufffd(Phila)"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Myocardial bridging (MB) occurs when a coronary artery, commonly the left anterior descending (LAD), has an intramyocardial course. In symptomatic patients who fail medical therapy, surgical unroofing can provide symptomatic relief by improving coronary blood flow. We present a series of patients undergoing robotic totally endoscopic beating-heart MB unroofing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>There were 34 patients with an LAD-MB who failed medical therapy and underwent robotic totally endoscopic, off-pump unroofing between January 2017 and October 2023. Patients were evaluated by a multidisciplinary team and underwent provocative coronary angiography to confirm hemodynamic significance. We reviewed perioperative outcomes and contacted patients for midterm follow-up, including completion of a modified Seattle Angina Questionnaire (SAQ).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The mean age was 48 \u00b1 8 years, and 56% were female patients. One patient had prior septal myectomy via sternotomy. All patients had significant dobutamine Pd\/Pa reduction on preoperative coronary angiography. One patient had atrial fibrillation and underwent concomitant ablation with left atrial appendage ligation. The mean procedure time was 140 \u00b1 69 min. All were completed totally endoscopically off-pump without intraoperative conversions. The mean MB length was 4.5 \u00b1 1.4 cm, and the mean depth was 1.6 \u00b1 0.9 cm. Of the patients, 76% were extubated in the operating room. The mean intensive care unit and hospital length of stay were 0.97 \u00b1 0.58 and 1.73 \u00b1 1.1 days, respectively. There were no mortalities or strokes. There was 1 postoperative take-back for bleeding. At midterm follow-up (19 \u00b1 14 months), 28 patients completed the SAQ; 86% reported \u201cmuch less angina\u201d during activity compared with before surgery, and 93% reported taking no antianginal medication since surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In appropriate patients with hemodynamically significant LAD-MB who fail medical therapy, robotic beating-heart unroofing is possible with good outcomes. Further studies are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15569845241266817","type":"journal-article","created":{"date-parts":[[2024,9,14]],"date-time":"2024-09-14T00:30:23Z","timestamp":1726273823000},"page":"409-415","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Robotic Totally Endoscopic Off-Pump Unroofing of Myocardial Bridge: Early Experience and Midterm Outcomes"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4448-9023","authenticated-orcid":false,"given":"Sarah","family":"Nisivaco","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Chicago Medicine, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Blair","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Chicago Medicine, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Chicago Medicine, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroto","family":"Kitahara","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Chicago Medicine, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tess","family":"Allan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Chicago Medicine, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Chicago Medicine, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charocka","family":"Coleman","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Chicago Medicine, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1154-8018","authenticated-orcid":false,"given":"Husam H.","family":"Balkhy","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, University of Chicago Medicine, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,9,13]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.09.859"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezab378"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)02490-9"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2022.06.002"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0000000000000551"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2020.02.014"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2016.08.035"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2013.07.079"},{"key":"e_1_3_2_10_2","article-title":"A chart review on surgical myocardial debridging in symptomatic patients: a safe procedure with good long-term clinical outcome and coronary computed tomographic angiography results","volume":"36","author":"Charaf Z","year":"2023","unstructured":"Charaf Z, Tanaka K, Wellens F, et al. A chart review on surgical myocardial debridging in symptomatic patients: a safe procedure with good long-term clinical outcome and coronary computed tomographic angiography results. Interdiscip Cardiovasc Thorac Surg 2023; 36: ivac286.","journal-title":"Interdiscip Cardiovasc Thorac Surg"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2020.11.023"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2019.07.005"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02768-7"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/anec.12492"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccl.2022.12.007"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-019-01935-1"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1510\/icvts.2009.221473"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.14094"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xjtc.2021.12.018"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/15569845231164374"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2021.10.049"}],"container-title":["Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845241266817","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15569845241266817","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15569845241266817","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:19:21Z","timestamp":1777461561000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15569845241266817"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1177\/15569845241266817"],"URL":"https:\/\/doi.org\/10.1177\/15569845241266817","relation":{},"ISSN":["1556-9845","1559-0879"],"issn-type":[{"value":"1556-9845","type":"print"},{"value":"1559-0879","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7]]}}}