Myocardial bridge is a benign congenital anomaly in which a segment of major epicardial coronary arteries descends into the myocardium for a variable distance. Myocardial bridge is most often single and located in the middle part of the left anterior descending artery. The presence of more than one myocardial bridge in coronary arteries is very rare. We present a patient with more than one myocardial bridge in the left anterior descending artery.The case was a 55- year old man, referred to our clinic with the complaint of atypical chest pain. In the radionuclide study a reversible ischemia in the anterior wall was found. For this abnormal finding, he underwent a coronary angiography and it showed two myocardial bridges in the mid and end segments of the left anterior descending artery.Since myocardial bridge is usually single, the present case with two consecutive myocardial bridges in one artery can be presented as a very rare case report.

Background and purpose: Aim of this research is to study the effect of bridging collateral vessels (BCVS) on the success of coronary angioplasty in patients with chronic total occlusion (CTO). In coronary angioplasty of CTO cases, categorizing of lessions characteristics can be helpful in evaluation of success in angioplasty. There are controversies about the role of BCVS in the rate of angioplasty success in OTC cases.Materials and methods: Seventy seven patients with angioplasty done in CTO lesions were selected for study, and divided in two groups. In the first group comprising of 97 patients, there was BCVS, and the second group (50 patients) had no BCVS.Results: Success was achieved in 11 patients from Group II (40.7% vs 82% p=0.0002 with relative risk of 3.9, and confidence interval of 95%, (1.7 to 6.4). Of 52 patients with successful angioplasty, rate of success with estimation of less than three months occlusion was more in patients with occlusion for more than three months (63.5% vs 47.5%), p=0.0001 and relative risk of 1.8, with confidence interval of 95%, (1.3 to 2.6). Presence of a side branch at the distance of ≥ 2mm to the occlusion point has been one of the predictor factors for unsuccessful angioplasty (p=0.0007, relative risk 2.9, with confidence interval of 95%, (1.5 to 5.6).Conclusion: Presence of some morphological variables in CTO during angioplasty of coronary vessels may be helpful in guiding successful angioplasty. One of them is presence of BCVS which seems to have inverse relation to the rate of successful angioplasty.

Myocardial bridging with systolic compression of the left anterior descending coronary artery (LAD) may be associated with myocardial ischemia. In symptomatic myocardial bridging unresponsive to medical treatment, surgical unroofing of the left LAD can be performed. Little information is available about the long-term prognosis of patients with this coronary anomaly after the surgical unroofing, so we decided to evaluate the result of this operation. A total of 26 patients underwent surgical unroofing of myocardial bridging. Patients had a myocardial bridge of at least 3 cm in length in the middle of LAD and with more than 70% compression during systole. Unroofing was performed with cardiopulmonary bypass in 16 and with off pump technique in 10 patients. In 6 patients repeat angiographies for control of myotomy were done. In one of them a nonsignificant 20% narrowing was seen. Postoperative scintigraphic and angiographic studies demonstrated restoration of coronary flow and myocardial perfusion without residual myocardial bridges under beta-stimulation in 24 patients. Two patients had residual narrowing. With off pump technique, 1 patient had perforation of the right ventricle and 1 patient underwent reoperation because of incomplete unroofing during the first operation. None of the patients with cardiopulmonary bypass technique had residual chest pain or other complications. Surgical unroofing of myocardial bridging with the aid of cardiopulmonary bypass is a safe and easy procedure with low operative risk and with excellent functional results.

Objective: we measured concept of bridging social capital by a new tool. All items used in the scale are in agreement with the theoretical literature on this concept.Method: The research method was survey. The sample population was 376 students of Isfahan university which were sampled through cluster sampling of multiple stages. After making a list and confirming the validity of questions by professors of social work and sociology, its reliability was confirmed through cronbach alpha coefficient. Findings: bridging social capital must be measured in three different dimensions: Different Interests, Different Lifestyle, and out groups.Results: Our scale is not only highly reliable, but also valid.

Background: In angioplasty of chronic total occlusion categorizing lesion characteristics may be useful for their impact on procedural success. There is controversy about the role of bridging collateral vessels in chronic total occlusion procedural outcome. This study investigated the effect of bridging collateral vessels on the success of coronary angioplasty in  patients with chronic total occlusions.Methods: Seventy seven consecutive patients undergoing coronary angioplasty for chronic total occlusion were classified into two groups. Group I patients had chronic total occlusion with bridging collateral vessels (27 patients), and patients in group II had not such vessels (50 patients). Results: Procedural success was achieved in 11 patients in group I and in 41 patients in group II (40.7% vs 82%; P=0.0002; relative risk 3.9; 95% confidence interval 1.7-6.4). Of 52 patients with successful results than patients with ≥3 months (63.5% vs 47.5%; P= 0.0001; relative risk 1.8; 95% confidence interval 1.3-2.6). Presence of a side branch of ≤2mm at occlusion point was a predictor of unsuccessful result (p=0.007; relative risk 2.9;95% confidence confidence interval 1.5-5.6). Conclusion: There are some morphologic variables which may be useful in guiding angioplasty in patients with chronic total coronary occlusion . presence of bridging collateral vessels is one of them , which appear to be inversely related to procedural success.