Background: We aimed to evaluate the graft patency rate following coronary artery bypass grafting (CABG) to the left anterior descending artery (LAD) with proximal myocardial bridging (MB). While MB is generally a benign coronary abnormality, ischemia, stunning, and sudden death have been reported. In symptomatic patients with proximal LAD systolic compression of >50%, positive for ischemic noninvasive testing and noneffective optimal medical therapy, coronary intervention could be indicated. Few studies of CABG in myocardial bridging have been reported. The influence of high flow in coronaries with MB on graft patency is cause for concern. Methods: We retrospectively studied 39 patients operated on for isolated MB of proximal LAD with >50% systolic compression. All patients were severely symptomatic despite optimal medical therapy and positive noninvasive tests for myocardial ischemia. CABG was performed through the midsternotomy with cardiopulmonary bypass and cardioplegia. Patients were divided into two groups: in 20 patients, LAD was bypassed with left internal mammary artery (LIMA) (Group 1) and in 19 patients with saphenous vein graft (SVG) (Group 2). All patients underwent follow-up coronary angiography. Results: Demographics and degree of systolic compression of the LAD were similar in both groups. There was no mortality or major morbidity. Freedom from angina was 68% in Group 1 and 94% in Group 2 at 18 months postoperatively (p = 0.58). Twelve LIMA grafts and three SVGs were found occluded (p = 0.002). Conclusions: LIMA patency in myocardial bridging of the LAD can be low. SVGs should be considered in cases of CABG for myocardial bridging.

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The analysis of the novel Lolita by Vladimir Nabokov (English and Russian versions) has revealed the peculiarities of the novel on the level of contents and the plot and on the lexical level. The results of the analysis make it possible to come to the conclusion that the novel is a multilevel structure, inherently Russian in culture in spite of the abundance of French words and the English context. As to its communicative organization, it is an implied dialogue between the author and the reader, it is a double-voiced discourse that serves the author and the narrator at the same time to expresses simultaneously two different intentions. Nevertheless, in spite of its Russian imprint, the novel may be considered a unique phenomenon of world culture. There is no doubt that the work of true bilinguals, to which the great Russian-American writer V.V. Nabokov, deserves special attention in view of combining ethnic and cultural codes and harmonious combination of different ethno-psycholinguistic rules of each language (Karabulatova & Polivara, 2013).

<p>Coarctation of the aorta is one of the most common congenital heart defects. Despite excellent early results of correcting isolated coarctation of the aorta in the neonatal period, in the long-term postoperative period such patients have an increased risk of cardiovascular events. Today there are numerous studies demonstrating the signs of complex cardiovascular remodeling in patients after surgical correction of coarctation of the aorta. Pathological ventricular-arterial interaction is considered to determine the structural and functional changes in the left ventricle and the biomechanical properties of the aorta, which continue after correction of the coarctation segment of the aorta. In this respect, ultrasound evaluation of the left ventricle mechanics and aorta becomes a valuable diagnostic tool for dynamic monitoring of structural and functional remodeling of the left ventricle and severity of arteriopathy. Such evaluation will allow timely to detect increasing risk of cardiovascular events and to correct therapeutic measures.</p><p><strong>Funding:</strong> The study had no sponsorship.<br /><strong></strong></p><p><strong>Conflict of interest:</strong> The authors declare no conflict of interest.<br /><strong></strong></p><p><strong>Authors’ contribution</strong></p><p><strong></strong>Conception and study design: E.N. Orekhova, T.V. Matanovskaya</p><p>Drafting the article: E.N. Orekhova</p><p>Critical revision of the article: Y.S. Sinelnikov</p><p>Final approval of the version to be published: Y.S. Sinelnikov, E.N. Orekhova, T.V. Matanovskaya<br /><strong></strong></p><p><strong>ORCID ID</strong></p><p>Y.S. Sinelnikov, <a href="https://orcid.org/0000-0002-6819-2980">https://orcid.org/0000-0002-6819-2980</a><br />E.N. Orekhova, <a href="https://orcid.org/0000-0002-7097-8771">https://orcid.org/0000-0002-7097-8771</a><br />T.V. Matanovskaya, <a href="https://orcid.org/0000-0002-2277-8935">https://orcid.org/0000-0002-2277-8935</a></p>

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