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The Annals of Thoracic Surgery, Vol 24, 422-429, Copyright © 1977 by The Society of Thoracic Surgeons

ARTICLES

Successful course after supraarterial myotomy for myocardial bridging and milking effect of the left anterior descending artery

P Grondin, MG Bourassa, J Noble, R Petitclerc and I Dydra

We report 3 patients having a grade II milking effect of the proximal left anterior descending artery (LAD) and suffering from angina. Preoperative myocardial ischemia was demonstrated by stress ECG in all 3 and by pacing and lactates studies in 2. Surgical decompression of the systolically constricted artery has resulted in disappearance of angina, milking, and ischemia. Severe milking of the LAD is a rare entity, probably congenital in origin, capable of producing myocardial ischemia and possibly causing sudden death. More studies regarding its etiology and pathophysiology are necessary. Biopsy of the myocardium surrounding the artery could be useful.

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