Guerra Miguel, Mota João Carlos
Department of Thoracic Surgery, Centro Hospitalar de Vila Nova de Gaia, Portugal.
Interact Cardiovasc Thorac Surg. 2012 Feb;14(2):176-82. doi: 10.1093/icvts/ivr080. Epub 2011 Nov 28.
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.
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。
