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混合冠状动脉血运重建术综述。

A review of hybrid coronary revascularization.

作者信息

Kayatta Michael Owen, Halkos Michael Emanuel

机构信息

Division of Cardiothoracic Surgery, Emory University School of Medicine, Atlanta, USA.

出版信息

Indian J Thorac Cardiovasc Surg. 2018 Dec;34(Suppl 3):321-329. doi: 10.1007/s12055-018-0763-7. Epub 2018 Nov 19.

Abstract

PURPOSE

Hybrid coronary revascularization is an emerging treatment strategy for coronary artery disease. We will review the reasons for the development of this strategy, describe surgical techniques, and review outcomes. Finally, we will discuss the future of hybrid revascularization and explain why it will grow as a treatment modality.

METHODS

For this review, we conducted an unstructured review of the literature for articles related to hybrid coronary revascularization, bypass surgery, and percutaneous coronary interventions.

RESULTS

Hybrid coronary revascularization has been shown in large series to have excellent results. These include fast recovery time, low mortality and rates of complications, and excellent surgical graft patency. There may be increased need for revascularization over conventional bypass surgery.

CONCLUSIONS

The combination improved surgical techniques including a robotic surgery platform, as well as the ever-improving efficacy and durability of coronary stents have made hybrid coronary revascularization an attractive option for many patients. It offers a minimally invasive approach to surgery while avoiding the poor patency of saphenous vein grafts. In appropriately selected patients, this may be an ideal treatment strategy that minimizes risks and maximizes short- and long-term benefits.

摘要

目的

杂交冠状动脉血运重建术是一种新兴的冠状动脉疾病治疗策略。我们将回顾这一策略发展的原因,描述手术技术,并回顾治疗结果。最后,我们将讨论杂交血运重建术的未来,并解释其作为一种治疗方式将会发展壮大的原因。

方法

对于本综述,我们对与杂交冠状动脉血运重建术、搭桥手术及经皮冠状动脉介入治疗相关的文献进行了非结构化回顾。

结果

大量研究表明杂交冠状动脉血运重建术效果极佳。这些优点包括恢复时间快、死亡率和并发症发生率低,以及手术移植血管通畅率高。与传统搭桥手术相比,可能需要更多的血运重建。

结论

包括机器人手术平台在内的改良手术技术,以及冠状动脉支架不断提高的疗效和耐用性,使杂交冠状动脉血运重建术成为许多患者的一个有吸引力的选择。它提供了一种微创手术方法,同时避免了大隐静脉移植血管通畅性差的问题。在适当选择的患者中,这可能是一种理想的治疗策略,可将风险降至最低,并使短期和长期益处最大化。

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Indian J Thorac Cardiovasc Surg. 2018 Dec;34(Suppl 3):321-329. doi: 10.1007/s12055-018-0763-7. Epub 2018 Nov 19.
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