冠状动脉手术中的新技术。
New technologies in coronary artery surgery.
作者信息
Taggart David, Nir Rony-Reuven, Bolotin Gil
机构信息
Professor of Cardiovascular Surgery, University of Oxford, England, UK;
出版信息
Rambam Maimonides Med J. 2013 Jul 25;4(3):e0018. doi: 10.5041/RMMJ.10118. Print 2013 Jul.
Coronary artery disease remains the leading cause of death in developed countries. Major recent studies such as SYNTAX and FREEDOM have confirmed that coronary artery bypass grafting (CABG) remains the gold standard treatment in terms of survival and freedom from myocardial infarction and the need for repeat revascularization. The current review explores the use of new technologies and future directions in coronary artery surgery, through 1) stressing the importance of multiple arterial conduits and especially the use of bilateral mammary artery; 2) discussing the advantages and disadvantages of off-pump coronary artery bypass; 3) presenting additional techniques, e.g. minimally invasive direct coronary artery bypass grafting, hybrid, and robotic-assisted CABG; and, finally, 4) debating a novel external stenting technique for saphenous vein grafts.
冠状动脉疾病仍是发达国家的主要死因。近期的主要研究如SYNTAX和FREEDOM研究已证实，就生存率、免于心肌梗死以及再次血运重建需求而言，冠状动脉旁路移植术（CABG）仍是金标准治疗方法。本综述通过以下方面探讨冠状动脉手术新技术的应用及未来方向：1）强调多支动脉桥的重要性，尤其是双侧乳内动脉的应用；2）讨论非体外循环冠状动脉旁路移植术的优缺点；3）介绍其他技术，如微创直接冠状动脉旁路移植术、杂交手术以及机器人辅助CABG；最后4）探讨一种用于大隐静脉桥的新型体外支架技术。
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