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Scripta Scientifica Medica

The relationship between the first layer of the myocardial bridge and the longitudinal axis of the under-bridge arterial segment

Mihail Tasnic, Ilia Catereniuc, Elena Costru-Tasnic

Abstract

Complete myocardial bridges (CMB) are myocardial bundles which cover a portion of the underepicardial coronary artery on one or more of its parts. Most frequently CMB cover the anterior interventricular branch, followed by the diagonal branches of both ventricles, first marginal branch and posterior interventricular branch. It is important to consider the association of several bridges on the same vessel or on different vessels. Microscopic picture of the under-bridge segments indicates that the term of myocardial bridge is arbitrary. Thus, while in thin myocardial bridges the direction of the myocardial fibers is similar to the basic layer, in thick bridges, especially those located on the anterior interventricular branch, myocardial fibers surround the vessel from all the parts and present a spiral orientation. Depending on the topography of the myocardial bridges, intramural vascular segment can be intersected by muscle bundles perpendicular, under an acute angle according to the longitudinal axis of the vessel or they can be oriented parallel to the vessel. According to the angle of intersection of the vessel by the muscle bundles, we could explain the different compression and strength levels of intramural vascular segment in different arterial segments. Histological study shows some morphological features, which would explain myocardial ischemia in some cases of intramural trajectory of large coronary arteries, such as deformation of the vessel, persistent vessel narrowing and narrow perivascular space.

Scripta Scientifica Medica 2013; 45(4): 59-65.


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DOI: http://dx.doi.org/10.14748/ssm.v45i4.236

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About The Authors

Mihail Tasnic
State University of Medicine and Pharmacy Nicolae Testemitanu of Chisinau
Moldova, Republic of

Ilia Catereniuc
State University of Medicine and Pharmacy Nicolae Testemitanu of Chisinau
Moldova, Republic of

Elena Costru-Tasnic
State University of Medicine and Pharmacy Nicolae Testemitanu of Chisinau
Moldova, Republic of

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