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综合冠状动脉再血管:穿皮冠状动脉干预加上机器人完全内镜冠状动脉旁路术
Marc R Katz1, Frank Van Praet, Didier de Canniere
1Cardiac & Thoracic Surgical Associates (M.R.K.), Richmond, VA, USA. mkatz@newheartsurgery.com
Circulation
|July 6, 2006
概括
机器人完全内透视冠状动脉绕道 (TECAB) 和穿皮冠状动脉干预 (PCI) 为多血管冠状动脉疾病提供了最少侵入性的选择. 这种混合策略显示出良好的LIMA透明度,但需要对其PCI再干预率进行进一步调查.
科学领域:
- 心血管外科心血管外科
- 干预心脏病学 干预心脏病学
- 最少侵入性手术的方法
背景情况:
- 多血管冠状动脉疾病 (CAD) 提出了治疗挑战.
- 为了改善患者的治疗结果,人们寻求最少的侵入性复血管化策略.
- 机器人完全内透视冠状动脉绕道术 (TECAB) 结合穿皮冠状动脉干预 (PCI) 提供了一种混合方法.
研究的目的:
- 评估用于多血管CAD的结合TECAB和PCI策略的安全性和有效性.
- 评估早期血管造影结果和手术成功率.
- 在这种混合治疗方法中确定优化潜在的领域.
主要方法:
- 对27名多血管CAD患者的回顾性分析,他们接受了第二个血管的LAD和PCI的TECAB.
- 用于TECAB的LIMA移植;在手术前,手术期间或手术后进行PCI.
- 三个月的血管造影随访和对结果的独立审查.
主要成果:
- 较高的LIMA动脉穿透率 (96.3%) 和可接受的PCI血管穿透率 (66.7%).
- 没有死亡或中风;术后发病率低 (心肌梗塞1次).
- 在PCI后,再干预率为29.6%,根据支架类型和时间变化.
结论:
- 集成的TECAB和PCI为多血管CAD提供了一个可行的,最少侵入性的选择.
- 该战略实现了优秀的LIMA移植通透性和低死亡/发病率.
- 比预期更高的PCI再干预率需要对支架选择,血管选择和程序时间进行进一步调查.
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