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不完全手术血运重建对生存的影响。

Impact of incomplete surgical revascularization on survival.

作者信息

Guerra Miguel, Mota João Carlos

机构信息

Department of Thoracic Surgery, Centro Hospitalar de Vila Nova de Gaia, Portugal.

出版信息

Interact Cardiovasc Thorac Surg. 2012 Feb;14(2):176-82. doi: 10.1093/icvts/ivr080. Epub 2011 Nov 28.

Abstract

Complete revascularization is considered superior to incomplete revascularization (IR), with better long-term survival and a lower rate of reintervention. However, it has yet to be established whether this difference is due directly to IR as a surgical strategy or whether this approach is merely a marker of more severe coronary disease and more rapid progression. We believe that IR is a prognostic marker for a more complex coronary pathology, and adverse effects are probably due to the preoperative condition of the patient. In fact, although IR may negatively affect long-term outcomes, it may be, when wisely chosen, the ideal treatment strategy in selected high-risk patients. IR can derive from a surgical strategy of target vessel revascularization, where the impact of surgery is minimized to reduce perioperative mortality and morbidity, aiming to achieve the best feasible safe revascularization.

摘要

完全血运重建被认为优于不完全血运重建(IR),具有更好的长期生存率和更低的再次干预率。然而,这种差异是直接归因于作为一种手术策略的IR,还是这种方法仅仅是更严重冠状动脉疾病和更快进展的一个标志,尚未确定。我们认为IR是更复杂冠状动脉病变的一个预后标志物,不良影响可能归因于患者的术前状况。事实上,尽管IR可能对长期结果产生负面影响,但在明智选择的情况下,它可能是选定的高危患者的理想治疗策略。IR可以源自靶血管血运重建的手术策略,在这种策略中,手术的影响被最小化以降低围手术期死亡率和发病率,旨在实现最佳可行的安全血运重建。

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