Myocardial bridge: is the risk of perforation increased?

It has been demonstrated that stent implantation in a myocardial bridge is associated with a high restenosis rate; however, coronary perforation caused by stent implantation has been reported. The present report describes two myocardial bridge cases with severe coronary rupture soon after stent implantation. Previous studies have reported that the diameter of the bridge vessels was less than that of the proximal and distal vessels; thus, coronary perforation may be due to stent oversizing. To determine the risks and benefits associated with this therapeutic option, interventional therapy should be critically evaluated, and careful selection of balloon and drug-eluting stent size using intravascular ultrasound is recommended.