急诊冠状动脉旁路移植术的研究进展

Advances in emergency coronary artery bypass grafting

急诊冠状动脉旁路移植术(ECABG)目前仍是临床上对出现心源性休克的急性心肌梗死(AMI)、经皮冠状动脉介入治疗(PCI)失败或血管造影意外、左主干合并多支血管病变和解剖不适用于PCI情况下进行血运重建和挽救患者生命的选择方式。但目前关于ECABG的手术指征、手术时机和手术方式选择方面仍有争议。本文根据欧洲心脏病学会(ESC)联合欧洲心胸外科协会(EACTS)于2018年发布的心肌血运重建指南,结合最新的研究结果,对ECABG的手术指征、手术时机和手术方式选择的最新研究进展作一综述。

Emergency coronary artery bypass grafting(ECABG)is an effective and major method for revascularization in patients with acute myocardial infarction(AMI)and cardiogenic shock,failed percutaneous coronary intervention(PCI),failure coronary angiography,multivessel disease,and coronary anatomy not suitable for PCI.However,there are still controversies about the surgical indications,timing of surgery,and surgical methods for ECABG.Based on the guidelines for myocardial revascularization issued by the European Society of Cardiology(ESC)and the European Association of Cardiothoracic Surgery(EACTS)in 2018,combined with the latest research results,this review discusses the surgical indications,timing of surgery,and the choice of surgical methods of ECABG.