Normalization of FFR CT after surgical unroofing of a myocardial bridge: a case report

Cardiac computed tomography angiography derived fractional flow reserve (FFR ) is a diastolic measurement and has emerged as a valuable non-invasive alternative to FFR in patients with stable coronary artery disease. It has, unlike FFR during coronary angiography, not been validated for the physiological evaluation of an isolated myocardial bridge (MB) so far. Our patient, previously known with a long myocardial bridge of the mid-segment of the left anterior descending artery, presented with a non-ST-segment elevation myocardial infarction that was treated by surgical unroofing of the MB. FFR after surgery confirms a major amelioration of coronary blood flow. Myocardial bridge may rarely present as a non-ST-segment elevation myocardial infarction. FFR has thus far been accepted as a useful diagnostic tool in stable coronary artery disease. Our case report suggests that cardiac computed tomography angiography may be considered a useful technique for anatomical and physiological evaluation of MBs.