Zhao Q, Yang Y, Zhu Y P
Department of Cardiac Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Zhonghua Wai Ke Za Zhi. 2020 May 1;58(5):337-340. doi: 10.3760/cma.j.cn112139-20200131-00050.
The selection of conduit has always been one of the most perennially debated topic in the field of coronary artery bypass grafting (CABG) . Arterial grafts have demonstrated excellent biological characteristics and long-term patency in CABG. Clinical observations and randomized clinical trials over the past two decades have shown that the internal thoracic artery is the gold standard graft. Multi-arterial and total-arterial CABG significantly improves patients' long-term survival, but there are technical challenges and concerns of sternal complication. Currently multi-arterial and total-arterial CABG are strongly advocated and increasingly applied worldwide. Several guidelines have been published and updated, as well as Chinese expert consensus. Coronary surgery in China is paving anupper stage of quality improvement. Arterial coronary artery bypass grafting should be carried out more broadly in China as evidence accumulation and excellent long-term clinical results.
在冠状动脉旁路移植术(CABG)领域,移植血管的选择一直是长期以来争论最多的话题之一。在冠状动脉旁路移植术中,动脉移植物已显示出优异的生物学特性和长期通畅性。过去二十年的临床观察和随机临床试验表明,胸廓内动脉是移植血管的金标准。多动脉和全动脉冠状动脉旁路移植术显著提高了患者的长期生存率,但存在技术挑战和胸骨并发症问题。目前,多动脉和全动脉冠状动脉旁路移植术在全球范围内得到大力提倡并越来越多地应用。已经发布并更新了多项指南以及中国专家共识。中国的冠状动脉外科手术正在迈向质量提升的新阶段。随着证据的积累和出色的长期临床结果,动脉冠状动脉旁路移植术在中国应得到更广泛的开展。