The diagnostic accuracy of coronary angiography to detect left anterior descending artery myocardial bridging in coronary artery bypass grafting: a retrospective single-center study

Abstract

Aims: The left anterior descending artery is the most involved vessel in the myocardial bridging of the coronary arteries. Revascularization of the left anterior descending artery (LAD) is considered an essential component of coronary artery bypass grafting (CABG) procedures. This study aims to evaluate the correlation between angiographic views of the coronary artery and intraoperative findings of the left anterior descending artery myocardial bridge (LADMB).
 Methods: The records of patients who underwent the CABG procedure between January 2015 and October 2022 were reviewed retrospectively. A total of 349 patients who had LADMB on coronary angiography (CAG) images and/or intraoperatively were evaluated. Patients were divided into two groups. The CAG group (n=50) consisted of patients with angiographic LADMB, and the CABG group (n=40) consisted of patients with LADMB that was detected intraoperatively. The correlation between myocardial bridge signs of the LAD in CAG and intraoperative observations was investigated.
 Results: In the coronary angiography group, 50 patients had signs of depression on coronary angiography, of whom 35 had LADMB intraoperatively. In the CABG group, 40 patients were found to have a myocardial bridge intraoperatively, and 5 had normal CAG images. The prevalence of LADMB was 11.5%. The sensitivity of CAG was 87.5%, the specificity was 95.15%, the positive predictive value was 70%, and the negative predictive value was 98.32%.
 Conclusion: The myocardial bridge signs of the LAD on CAG correlate with intraoperative observations with high sensitivity and specificity.