Nedadur Rashmi, Medina Melissa, Lehtinen Miia, Bryner Benjamin, Johnston Douglas R
Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine and Northwestern Medicine Bluhm Cardiovascular Institute, Arthur J. Rubloff Building, 420 East Superior Street, Chicago, IL 60611, USA.
Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine and Northwestern Medicine Bluhm Cardiovascular Institute, Arthur J. Rubloff Building, 420 East Superior Street, Chicago, IL 60611, USA; McGaw Medical Center of Northwestern University.
Heart Fail Clin. 2025 Apr;21(2):287-294. doi: 10.1016/j.hfc.2025.01.004.
Coronary artery bypass grafting is the major modality of coronary revascularization in patients with ischemic cardiomyopathy as it provides surgical collateralization of the coronary bed protecting the functional myocardium. Myocardial viability testing does not have an established role in the surgical evaluation. Concomitant surgical ventricular restoration does not improve symptoms or survival, though patients with large aneurysms and significant reduction in ventricular size could benefit. Correction of functional mitral regurgitation does not improve survival, and severe functional mitral regurgitation should be addressed via mitral valve replacement. Temporary mechanical circulatory support can be used as a bridge to recovery.
冠状动脉旁路移植术是缺血性心肌病患者冠状动脉血运重建的主要方式，因为它能为冠状动脉床提供外科侧支循环，保护有功能的心肌。心肌存活能力检测在外科评估中尚无明确作用。同期进行的外科心室修复并不能改善症状或提高生存率，不过有大室壁瘤且心室大小显著缩小的患者可能会从中获益。功能性二尖瓣反流的纠正并不能提高生存率，严重的功能性二尖瓣反流应通过二尖瓣置换术来解决。临时机械循环支持可作为恢复的桥梁。
