Department of Cardiothoracic Surgery, Friedrich-Schiller-University of Jena, Am Klinikum 1, 07747, Jena, Germany.
Clin Res Cardiol. 2017 Nov;106(11):851-867. doi: 10.1007/s00392-017-1113-2. Epub 2017 Apr 10.
For the year 2016, more than 20,000 published references can be found in Pubmed when entering the search term "cardiac surgery". Publications last year have helped to more clearly delineate the fields where classic surgery and modern interventional techniques overlap. The field of coronary bypass surgery (partially compared to percutaneous coronary intervention) was enriched by five large prospective randomized trials. The value of CABG for complex coronary disease was reconfirmed and for less complex main stem lesions, PCI was found potentially equal. For aortic valve treatment, more evidence was presented for the superiority of transcatheter aortic valve implantation for patients with intermediate risk. However, the 2016 evidence argued against the liberal expansion to the low-risk field, where conventional aortic valve replacement still appears superior. For the mitral valve, many publications emphasized the significant impact of mitral valve reconstruction on survival in structural mitral regurgitation. In addition, there were many relevant and other interesting contributions from the purely operative arena in the fields of coronary revascularization, surgical treatment of valve disease, terminal heart failure (i.e., transplantation and ventricular assist devices), and aortic surgery. While this article attempts to summarize the most pertinent publications it does not have the expectation of being complete and cannot be free of individual interpretation. As in recent years, it provides a condensed summary that is intended to give the reader "solid ground" for up-to-date decision-making in cardiac surgery.
2016 年,在 PubMed 中输入搜索词“心脏外科”,可以找到超过 20000 篇已发表的参考文献。去年的出版物有助于更清楚地划定经典外科和现代介入技术重叠的领域。冠状动脉旁路移植术(与经皮冠状动脉介入治疗部分相比)领域的研究因五项大型前瞻性随机试验而得到丰富。CABG 在复杂冠状动脉疾病中的价值得到了再次确认,而对于不太复杂的主干病变,PCI 被认为具有同等的效果。在主动脉瓣治疗方面,更多证据表明,经导管主动脉瓣植入术对中危患者具有优越性。然而,2016 年的证据表明,在低危领域不应扩大使用这种方法,因为传统的主动脉瓣置换术在该领域仍具有优势。对于二尖瓣,许多出版物强调了二尖瓣重建对结构性二尖瓣反流患者生存的重要影响。此外,在冠状动脉血运重建、瓣膜疾病的手术治疗、终末期心力衰竭(即移植和心室辅助设备)以及主动脉手术等领域,还有许多相关和其他有趣的纯手术领域的贡献。虽然本文试图总结最重要的出版物,但并不期望其内容完整,也不能没有个人的解释。与近年来一样,它提供了一个浓缩的总结,旨在为读者提供心脏外科最新决策的“坚实基础”。