1 Cardiac Surgery Department, Director of "Henry Dunant" Hospital, Athens, Greece ; 2 Cardiothoracic Surgery Department, "Saint" Luke Private Hospital, Thessaloniki, Panorama, Greece ; 3 Pulmonary Department-Oncology Unit, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 4 Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece ; 5 Internal Medicine Department, "Theageneio" Anticancer Hospital, Thessaloniki, Greece ; 6 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece.
J Thorac Dis. 2014 Mar;6 Suppl 1(Suppl 1):S2-6. doi: 10.3978/j.issn.2072-1439.2013.10.25.
The primary issues must be discussed regarding the decision making of treating a patient with chronic coronary artery disease (CAD), are the appropriateness of revascularization and the method which will be applied. The criteria will be the symptoms, the evidence of ischemia and the anatomical complexity of the coronary bed. Main indications are persistence of symptoms, despite oral medical treatment and the prognosis of any intervention. The prognosis is based on left ventricular function, on the number of coronary arteries with significant stenosis and the ischemic burden. For patients with symptoms and no evidence of ischemia, there is no benefit from revascularization. If ischemia is proven, revascularization is beneficial. If revascularization is decided, the next important issue must be taken under consideration is the choice of the appropriate method to be applied, surgical or interventional approach. Current treatment options will be presented.
在决定治疗慢性冠状动脉疾病 (CAD) 患者时，必须讨论主要问题，包括血运重建的适当性和应用的方法。标准是症状、缺血证据和冠状动脉床的解剖复杂性。主要适应证是尽管进行了口服药物治疗，但症状仍持续存在，以及任何干预的预后。预后基于左心室功能、有显著狭窄的冠状动脉数量和缺血负担。对于有症状但无缺血证据的患者，血运重建没有益处。如果证实存在缺血，血运重建是有益的。如果决定进行血运重建，下一个需要考虑的重要问题是选择适当的方法，即手术或介入方法。将介绍当前的治疗选择。
