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再次行冠状动脉旁路移植术的时代——高级 PCI 时代。

Redo Coronary Artery Bypass Grafting in the era of Advanced PCI.

机构信息

School of Medicine, University of Liverpool, Liverpool, United Kingdom.

Department of Cardiothoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom.

出版信息

Braz J Cardiovasc Surg. 2022 Aug 16;37(4):546-553. doi: 10.21470/1678-9741-2019-0206.

Abstract

OBJECTIVE

To review the evidence behind the role and relevance of redo coronary artery bypass grafting (CABG) in the current practice of percutaneous coronary intervention (PCI).

METHODS

A comprehensive electronic literature search was performed to identify articles that discuss the practice of PCI and redo CABG in patients that require coronary revascularization. All relevant studies are summarized in narrative manner to reflect current indications and preference.

RESULTS

The advancement in utilization of PCI has reduced the rate of redo CABG in patients with previous CABG that requires revascularization of an already treated coronary disease or a new onset of coronary artery stenosis. Redo CABG is associated with satisfactory perioperative outcomes but higher mortality at immediate postoperative period when compared to PCI.

CONCLUSION

Redo CABG patients are less likely to develop comorbidities associated with revascularisation, but the operative mortality is higher and long-term survival rates are similar in comparison to PCI. There is a need for further research into the role of redo CABG in the current advanced practice of PCI.

摘要

目的

回顾在当前经皮冠状动脉介入治疗(PCI)实践中再次冠状动脉旁路移植术(CABG)的作用和相关性的证据。

方法

进行了全面的电子文献检索,以确定讨论需要冠状动脉血运重建的患者中进行 PCI 和再次 CABG 实践的文章。以叙述的方式总结所有相关研究,以反映当前的适应证和偏好。

结果

PCI 的应用不断进步,减少了既往 CABG 患者中再次 CABG 的比率,这些患者需要对已治疗的冠状动脉疾病或新出现的冠状动脉狭窄进行血运重建。与 PCI 相比,再次 CABG 围手术期结果令人满意,但术后即刻死亡率更高。

结论

与 PCI 相比,再次 CABG 患者发生与血运重建相关的合并症的可能性较小,但手术死亡率更高,长期生存率相似。需要进一步研究再次 CABG 在当前先进的 PCI 实践中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/763c/9423790/c92647e1bd51/rbccv-37-04-0546-g01.jpg

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