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冠状动脉内膜切除术:旧术式的新变化

Coronary endarterectomy: new flavors from old recipes.

作者信息

Papakonstantinou Nikolaos A, Baikoussis Nikolaos G, Apostolakis Efstratios

机构信息

General Surgery Department, General Oncology Hospital "Agioi Anargyroi", 41 Kaliftaki Street, P.C. 14564, Kifisia, Athens, Greece.

Cardiac Surgery Department, L'Institut Mutualiste Montsuris, 42 BD Jourdan, 75014 Paris Cedex 14, France.

出版信息

J Cardiol. 2014 Jun;63(6):397-401. doi: 10.1016/j.jjcc.2014.02.005. Epub 2014 Mar 24.

Abstract

Coronary endarterectomy is an old surgical procedure against coronary artery disease first described by Baily et al. in 1957. Despite its first adverse results, several current publications have shown that coronary endarterectomy with on-pump or off-pump coronary artery bypass grafting can be safely performed with acceptable mortality, morbidity, and angiographic patency rates. Coronary endarterectomy can assure complete revascularization supplying the myocardium with satisfactory blood flow in cases of a diffusely diseased left anterior descending artery or diffuse calcification, thus preventing residual ischemia. Hence, it is important to evaluate current results, rethink this old recipe, and redefine its indications.

摘要

冠状动脉内膜切除术是一种治疗冠状动脉疾病的古老外科手术,最早由贝利等人于1957年描述。尽管其最初有不良结果,但目前的一些出版物表明,在体外循环或非体外循环冠状动脉旁路移植术中进行冠状动脉内膜切除术可以安全地实施,死亡率、发病率和血管造影通畅率均可接受。在左前降支弥漫性病变或弥漫性钙化的情况下,冠状动脉内膜切除术可以确保心肌获得满意血流的完全血运重建,从而预防残余缺血。因此,评估当前结果、重新审视这个古老的方法并重新定义其适应症很重要。

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