Cardiovascular Division, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
Catheter Cardiovasc Interv. 2010 Mar 1;75 Suppl 1:S28-34. doi: 10.1002/ccd.22402.
Coronary artery bypass surgery is beneficial in patients with complex coronary artery disease. The longevity of the left internal mammary artery (LIMA) placed to the left anterior descending (LAD) artery (LIMA-LAD) is between 92-99% at 15 years, and contributes substantially to the survival advantage in patients treated with surgical revascularization. The long-term patency of saphenous vein grafts (SVGs), commonly used (>95%) in surgical revascularization procedures, is less well-established, with up to 26% of SVGs failing in the first year. In selected patients, particularly in those patients with vessels poorly suited to SVGs, hybrid myocardial revascularization (HMR) has been used, combining a minimally invasive approach to the LIMA-LAD with drug-eluting stent placement of the non-LAD vessels. The advantages and disadvantages of hybrid myocardial revascularization are reviewed in this report.
冠状动脉旁路移植术对复杂冠状动脉疾病患者有益。左内乳动脉（LIMA）桥接至前降支（LAD）动脉（LIMA-LAD）的 15 年存活率为 92-99%，并为接受手术血运重建治疗的患者带来显著的生存优势。在手术血运重建中常用（>95%）的大隐静脉移植物（SVG）的长期通畅性不太稳定，第一年就有多达 26%的 SVG 失败。在某些特定患者中，尤其是那些血管不适合 SVG 的患者中，已经应用了杂交心肌血运重建（HMR），将 LIMA-LAD 的微创方法与非 LAD 血管的药物洗脱支架置入相结合。本报告回顾了杂交心肌血运重建的优缺点。
