First in Human-Bioadaptor Stenting in Myocardial Bridging.

In current practice, stenting a myocardial bridging segment is known to be associated with dire consequences such as stent fracture and in-stent restenosis, thus it should best be avoided. However, sometimes stenting a bridging segment may be deemed necessary due to various reasons. We present a case in which an unintended dissection extended into a bridging segment, warranting stenting. We studied the effect of the bioadaptor stent, with its unique uncaging element, in such a segment using optical coherence tomography (OCT). Reangiogram 8 months after the index procedure showed a satisfactory result with no stent-related complications, while OCT showed preservation of bridging vasomotion as well as a positive remodeling effect in the stented bridging segment. Bioadaptor stenting in the myocardial bridging segment can provide scaffold support, preserve the bridging vasomotion, and bring about a positive remodeling effect. This finding may impact future practice on stenting strategies in myocardial bridging, should it be necessary; however, further studies are required to validate this concept and its applicability to other bridging cases.