Gaudino Mario F L, Spadaccio Cristiano, Taggart David P
Department of Cardiothoracic Surgery, Weill Cornell Medicine, NewYork-Presbyterian Hospital, 525 East 68th Street, New York, NY 10021, USA.
Department of Cardiothoracic Surgery, Golden Jubilee National Hospital, Agamemnon Street, Clydebank, Glasgow G81 4DY, UK; University of Glasgow, Institute of Cardiovascular and Medical Sciences, 126 University Place, Glasgow G128TA, UK.
Interv Cardiol Clin. 2019 Apr;8(2):173-198. doi: 10.1016/j.iccl.2018.11.007. Epub 2019 Jan 28.
Despite the progressive expansion of clinical indications for percutaneous coronary intervention and the increasingly high risk profile of referred patients, coronary artery bypass grafting (CABG) remains the mainstay in multivessel disease, providing good long-term outcomes with low complication rates. Multiple arterial grafting, especially if associated with anaortic techniques, might provide the best longer-term outcomes. A surgical approach individualized to the patients' clinical and anatomic characteristics, and surgeon and team experience, are key to excellent outcomes. Current evidence regarding patient selection, indications, graft selection, and potential strategies to optimize outcomes in patients treated with CABG is summarized.
尽管经皮冠状动脉介入治疗的临床适应症不断扩大，且转诊患者的风险状况日益增高，但冠状动脉旁路移植术（CABG）仍是多支血管病变的主要治疗方法，能提供良好的长期疗效且并发症发生率低。多支动脉移植，尤其是与非体外循环技术联合应用时，可能会带来最佳的长期疗效。根据患者的临床和解剖特征以及外科医生和团队的经验制定个体化的手术方案，是取得优异疗效的关键。本文总结了目前关于冠状动脉旁路移植术患者选择、适应症、移植物选择以及优化治疗效果的潜在策略的证据。
