We report a case of a patient who presented with non Wrist Brace ST-elevation myocardial infarction and coronary angiography showing a long myocardial bridge (MB) of the left anterior descending artery (LAD) with a fixed significant stenosis at the entry point of the MB.The lesion was treated with a semi-compliant balloon and drug-eluted stent (DES).After the stent placement, a large arterial perforation with fistula to right ventricle was observed.There was no hemodynamic instability due to the fistula progression during the procedure and the perforation point was successfully closed with a stent-graft.
Additionally, we provide a short review of diagnostic and WALKING STICKS therapeutic approach to MB stenting and reports of cases with coronary artery perforation after stenting of MB.