在经皮冠状动脉介入治疗（PCI）时代，冠状动脉外科医生保持“竞争力与合作精神”的策略。
Strategies for the coronary surgeon to remain "competitive and co-operative" in the PCI era.
作者信息
Valooran George Jose, Nair Shiv Kumar, Chandrasekharan Krishnan
机构信息
Consultant, Department of Cardiovascular and Thoracic Surgery, Rajagiri Hospital, India.
Senior Consultant and HOD, Department of Cardiovascular and Thoracic Surgery, Rajagiri Hospital, India.
出版信息
Indian Heart J. 2015 Jul-Aug;67(4):351-8. doi: 10.1016/j.ihj.2015.05.002. Epub 2015 Jul 8.
BACKGROUND
The advent of percutaneous intervention has made surgical treatment of coronary artery disease less favored by patients though the evidence that supports CABG in certain patient subsets is strong.
METHODS
Literature review was done using Pubmed, Scopus, Google and Google Scholar with MeSH terms-coronary artery bypass grafting, internal mammary artery, drug eluting stent, stroke, myocardial revascularization.
RESULTS
The adoption of evolving techniques like anaortic off pump grafting, bilateral internal mammary artery use, hybrid and minimally invasive coronary revascularization techniques, intra-operative graft assessment, and heart team approach can lead to better outcomes following surgery as is evidenced by recent literature.
CONCLUSIONS
Though the adoptability of the newer strategies may vary between centers a close coalition between coronary surgeons and cardiologists would ensure that the management of coronary artery disease is based on evidence for the benefit of the patient.
背景
尽管有充分证据表明在某些患者亚组中行冠状动脉旁路移植术（CABG）有益，但经皮介入治疗的出现使冠心病的外科治疗不太受患者青睐。
方法
使用PubMed、Scopus、谷歌和谷歌学术进行文献综述，检索词为——冠状动脉旁路移植术、乳内动脉、药物洗脱支架、中风、心肌血运重建。
结果
采用诸如非体外循环冠状动脉搭桥术、双侧乳内动脉的使用、杂交及微创冠状动脉血运重建技术、术中移植物评估以及心脏团队模式等不断发展的技术，可使术后获得更好的结果，近期文献已证实这一点。
结论
尽管各中心对新策略的采用情况可能有所不同，但冠状动脉外科医生和心脏病专家之间的紧密合作将确保基于证据对冠心病进行管理，以造福患者。
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