Right ventricular crypts in a myocardial bridge: Relevance to surgical relief

Crypts are very thin walled invaginations from the cavity of the left ventricle into the compact myocardium. With the advent and increased application of multimodality imaging, crypts are being increasingly identified in both normal individuals and patients, with various conditions including HCM, before and after the development of LV hypertrophy, LV non-compaction and hypertensive heart disease. to date crypts have not been described in the right ventricle. We here describe for the first time, RV crypts which were extending into a myocardial bridge, in a patient with HCM and dynamic obstruction of the LAD coronary artery. We also document and discuss the serious complications which can arise from crypts, and highlight the importance of preoperative identification of crypts. Further studies are required to determine the fetal origin of crypts and their clinical significance