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Hybrid 冠状动脉血运重建的现状。

The Current State of Hybrid Coronary Revascularization.

机构信息

Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York.

Department of Cardiothoracic Surgery, New York University Grossman School of Medicine, New York, New York.

出版信息

Ann Thorac Surg. 2024 Aug;118(2):318-328. doi: 10.1016/j.athoracsur.2024.04.010. Epub 2024 Apr 25.

Abstract

Hybrid coronary revascularization (HCR) combines a minimally invasive surgical approach with percutaneous coronary intervention (PCI) for the treatment of multivessel coronary artery disease. Despite decades of use, widespread acceptance has been limited. In this review, we conduct a comparative assessment of HCR in relation to traditional coronary artery bypass graft surgery and multivessel PCI. Although large-scale randomized data are still lacking, numerous studies have demonstrated that HCR may offer benefits regarding resource utilization and short-term morbidity while delivering comparable mid- and long-term survival compared with traditional bypass surgery. Compared with PCI, HCR may offer similar periprocedural morbidity while mitigating the need for repeat revascularization by providing a surgical arterial bypass graft to the left anterior descending artery.

摘要

杂交血运重建(HCR)将微创外科方法与经皮冠状动脉介入治疗(PCI)相结合,用于治疗多支冠状动脉疾病。尽管使用了几十年,但广泛接受的程度仍然有限。在这篇综述中,我们对 HCR 与传统冠状动脉旁路移植术和多支血管 PCI 进行了比较评估。尽管仍缺乏大规模的随机数据,但许多研究表明,与传统旁路手术相比,HCR 在资源利用和短期发病率方面可能具有优势,同时提供了相似的中期和长期生存率。与 PCI 相比,HCR 可能具有相似的围手术期发病率,同时通过为左前降支提供手术动脉旁路移植来减轻重复血运重建的需要。

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