Impact of Myocardial Bridges on Long-Term Outcomes After Left Anterior Descending Chronic Total Occlusion Recanalization.

Authors

Yingyang Geng, Tongqiang Zou, Changdong Guan, Yin Zhang, Jingjing Xu, Haibo Liu, Jue Chen, Yongjian Wu, Jie Qian, Kefei Dou, Weixian Yang, Yuejin Yang, Lei Song

Published in

JACC. Cardiovascular interventions. Volume 19. Issue 16. Pages 2220-2230. Aug 24, 2026.

Abstract

A myocardial bridge (MB) is frequently observed after recanalization of a left anterior descending coronary artery (LAD) chronic total occlusion (CTO); however, the long-term prognostic impact of MBs in this specific setting remains controversial.
The aim of this study was to determine the impact of MBs on long-term outcomes in patients undergoing percutaneous coronary intervention of LAD CTOs.
Consecutive patients with LAD CTOs who underwent intravascular ultrasound-guided percutaneous coronary intervention from January 2019 to December 2021 were retrospectively analyzed. The primary endpoint was the 5-year rate of major adverse cardiac events (MACE), a composite of cardiac death, spontaneous myocardial infarction, and ischemia-driven revascularization.
Among 685 patients analyzed, MBs were identified in 393 (57.4%) on intravascular ultrasound; stent extension into the bridged segment occurred in 44.3% of these cases (174 of 393). After a median 5-year follow-up, patients with MBs had a higher incidence of MACE compared with those without MBs (16.1% vs 8.9%; P = 0.006), driven primarily by more ischemia-driven revascularization in the MB group (15.1% vs 7.9%; P = 0.004). Stent extension into the MB was associated with a higher rate of MACE compared with sparing the MB (21.4% vs 11.9%; P = 0.0017). MACE rates did not differ between patients with MBs spared from stenting and those without MBs (11.9% vs 8.9%; P = 0.25).
MBs are prevalent after LAD CTO recanalization. Although their presence is associated with adverse outcomes, the risk is driven mainly by stent extension into the bridged segment.

PMID:
42637293
Bibliographic data and abstract were imported from PubMed on 25 Aug 2026.

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