攻克微创外科最后的堡垒——冠心病微创外科手术治疗的进展及评述

Capture the last bastion of minimally invasive surgery:the progress of minimally invasive direct coronary artery bypass grafting

冠心病是目前威胁人类健康的主要疾病之一,传统的冠状动脉血运重建方法主要分为介入治疗(PCI)及正中开胸冠状动脉旁路移植术(CABG),冠状动脉病变的复杂程度及手术带来的潜在风险决定了2种策略不同的适应证。近年来,随着微创心脏外科手术的发展以及内外科医生合作的心脏中心的建立,使得冠状动脉外科不断向着微创化的方向发展,微创冠状动脉外科已经成为传统血运重建治疗方式的有效补充。在保证治疗效果的前提下,微创手术可以减轻手术创伤,缩短术后恢复时间,为患者带来更好的医疗体验。

Coronary artery disease is one of the major threatens on human being health,and the conventional revascularization therapy includes percutaneous coronary intervention(PCI)and coronary artery bypass grafting(CABG).The complexity of coronary artery disease and the pros and cons of PCI and CABG are the foundations the two different therapies.In the contemporary era,with the development of minimally invasive coronary artery surgery and the innovation of exposure devices,minimally invasive coronary surgeries and the procedures with different degrees of combination with PCI,that is the hybrid procedures,already have taken a position for coronary revascularization.On the premise of safety,minimally invasive direct coronary artery bypass grafting(MIDCAB),hybrid coronary revascularization(HCR),and multi-vessel minimally invasive coronary surgery-CABG(MICS-CABG)could reduce the injuries of the bypass procedure and the recovery time,and so that patients could enjoy better medical experience.