Jung Joon Chul, Park Kay-Hyun
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang-gu, Seongnam-si, Gyeonggi-do 13620 Republic of Korea.
Indian J Thorac Cardiovasc Surg. 2022 Apr;38(Suppl 1):115-121. doi: 10.1007/s12055-021-01265-3. Epub 2021 Nov 8.
Coexisting coronary artery disease is a significant risk factor of untoward outcomes after surgical and endovascular aortic repair. This article reviewed the data, consensus, and remaining controversy about the diagnosis and management of coexisting coronary artery disease in the patients who require intervention for aortic aneurysm and dissection. It can be summarized as follows: (1) the current guidelines generally recommend the same diagnostic algorithm, including indications of coronary artery angiography, as one for non-surgical patients; (2) they also recommend the same indications of coronary revascularization; and (3) there are minor, but important, remaining issues regarding the details of management and surgical techniques most of which are still at the discretion of individual surgeons and institutions. Because it is not likely to get large-scale investigational data about these issues, the collection of individual experiences should be promoted in future scientific meetings to build up the consensus.
并存的冠状动脉疾病是外科手术和血管内主动脉修复术后不良结局的重要危险因素。本文回顾了关于需要接受主动脉瘤和主动脉夹层干预治疗的患者并存冠状动脉疾病的诊断和管理的数据、共识以及尚存的争议。总结如下：（1）当前指南通常推荐与非手术患者相同的诊断算法，包括冠状动脉造影的指征；（2）它们还推荐相同的冠状动脉血运重建指征；（3）在管理细节和手术技术方面仍存在一些虽小但重要的问题，其中大多数仍由外科医生和机构自行决定。由于不太可能获得关于这些问题的大规模研究数据，未来应在科学会议上促进个人经验的收集以达成共识。
