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State of the Art Surgical Coronary Revascularization最新文献

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The radial artery 桡动脉
State of the Art Surgical Coronary Revascularization Pub Date : 2021-01-01 DOI: 10.1093/MED/9780198758785.003.0046
R. Tranbaugh, M. Gaudino, B. Buxton, J. Tatoulis
{"title":"The radial artery","authors":"R. Tranbaugh, M. Gaudino, B. Buxton, J. Tatoulis","doi":"10.1093/MED/9780198758785.003.0046","DOIUrl":"https://doi.org/10.1093/MED/9780198758785.003.0046","url":null,"abstract":"The radial artery is an easily harvested, versatile, and high-quality conduit with proven safety and efficacy during coronary artery bypass grafting. When properly harvested and deployed, the long-term patency is excellent and similar to the left internal thoracic artery. Either open or endoscopic harvesting may be used and target vessel stenosis should be at least 70%. Radial artery grafting is superior to saphenous vein grafting and appears to be equivalent to using the right internal thoracic artery. Adoption of radial artery grafting may be the most direct path to routine multiple arterial bypass grafting in the majority of patients undergoing coronary artery bypass grafting.","PeriodicalId":199690,"journal":{"name":"State of the Art Surgical Coronary Revascularization","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131921933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of cardiopulmonary bypass 体外循环的管理
State of the Art Surgical Coronary Revascularization Pub Date : 2021-01-01 DOI: 10.1093/MED/9780198758785.003.0034
R. Baker, D. Fitzgerald, R. Groom
{"title":"Management of cardiopulmonary bypass","authors":"R. Baker, D. Fitzgerald, R. Groom","doi":"10.1093/MED/9780198758785.003.0034","DOIUrl":"https://doi.org/10.1093/MED/9780198758785.003.0034","url":null,"abstract":"Cardiopulmonary bypass provides the surgical team with the most controlled environment to perform the precise anastomoses needed for a successful coronary artery bypass graft operation. It not only promotes the most stable surgical field, but it utilizes a range of techniques that benefit both the surgeon and the patient. This chapter aims to provide the surgical team with an outline of cardiopulmonary bypass circuit components and an overview of common technical issues that diminish the adequacy of perfusion, and to direct the team to resources available in order to achieve evidence-based clinically safe cardiopulmonary bypass.","PeriodicalId":199690,"journal":{"name":"State of the Art Surgical Coronary Revascularization","volume":"194 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132355006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Epidemiology of ischaemic heart disease 缺血性心脏病流行病学
State of the Art Surgical Coronary Revascularization Pub Date : 2021-01-01 DOI: 10.1093/MED/9780198758785.003.0002
N. Townsend
{"title":"Epidemiology of ischaemic heart disease","authors":"N. Townsend","doi":"10.1093/MED/9780198758785.003.0002","DOIUrl":"https://doi.org/10.1093/MED/9780198758785.003.0002","url":null,"abstract":"Ischaemic heart disease (IHD) is the most common cause of death globally. However, the worldwide burden from IHD comes not only from the deaths attributable to it, but also from the disability it causes in those who survive with it. Both mortality and morbidity from IHD is greater in men than women, with large inequalities also existing between countries and global regions. This is particularly noticeable when comparing countries of different income classifications, with more than three-quarters of all IHD deaths occurring in developing countries and the lowest age-standardized mortality rates for IHD found in high-income countries.","PeriodicalId":199690,"journal":{"name":"State of the Art Surgical Coronary Revascularization","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124317291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Coronary endothelial function 冠状动脉内皮功能
State of the Art Surgical Coronary Revascularization Pub Date : 2021-01-01 DOI: 10.1093/med/9780198758785.003.0004
R. Jay Widmer, A. Lerman
{"title":"Coronary endothelial function","authors":"R. Jay Widmer, A. Lerman","doi":"10.1093/med/9780198758785.003.0004","DOIUrl":"https://doi.org/10.1093/med/9780198758785.003.0004","url":null,"abstract":"The assessment of coronary endothelial function has profound importance in terms of diagnostic and prognostic significance in patients with both obstructive and non-obstructive coronary artery disease. Endothelial dysfunction may take place in both epicardial coronary arteries as well as in the coronary microcirculation. Epicardial coronary endothelial dysfunction can be detected in the catheterization laboratory with abnormal vascular responses to endothelial-dependent physiological or pharmacological stimuli, and is characteristically a precursor to the initial processes of atherosclerotic coronary disease. This chapter discusses coronary endothelial physiology, the prevalence of endothelial dysfunction, how to evaluate coronary endothelial function, and the prognosis for patients with endothelial dysfunction.","PeriodicalId":199690,"journal":{"name":"State of the Art Surgical Coronary Revascularization","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115315952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardioplegia strategies 心麻痹策略
State of the Art Surgical Coronary Revascularization Pub Date : 2021-01-01 DOI: 10.1093/med/9780198758785.003.0036
C. Athanasuleas, G. Buckberg
{"title":"Cardioplegia strategies","authors":"C. Athanasuleas, G. Buckberg","doi":"10.1093/med/9780198758785.003.0036","DOIUrl":"https://doi.org/10.1093/med/9780198758785.003.0036","url":null,"abstract":"There are many cardioplegic strategies for coronary surgery. The goal is a dry operative field while maximizing myocardial recovery. Prospective randomized clinical trials have historically been difficult to achieve because of confounding variables such as solution used, route of administration, temperature, and so forth. This chapter describes an ‘integrated method’ of cardioplegia, so named because it combines many of the salient feature of various methods. It is designed to provide the maximum metabolic support of the myocardium during each phase of the operation. A vast literature from the laboratory to the bedside supports its use. Perhaps most importantly, integrated cardioplegia provides excellent protection of the septum and avoids paradoxical septal motion that may be a form of myocardial injury which is common with other methods of myocardial protection. Any future evaluation of cardioplegia methods should include not only survival but enzyme release and echocardiographic measurements of septal function.","PeriodicalId":199690,"journal":{"name":"State of the Art Surgical Coronary Revascularization","volume":"109 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117193193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The right gastroepiploic artery graft 右胃网膜动脉移植
State of the Art Surgical Coronary Revascularization Pub Date : 2021-01-01 DOI: 10.1093/med/9780198758785.003.0047
H. Suma, G. Tavilla, Ki-Bong Kim
{"title":"The right gastroepiploic artery graft","authors":"H. Suma, G. Tavilla, Ki-Bong Kim","doi":"10.1093/med/9780198758785.003.0047","DOIUrl":"https://doi.org/10.1093/med/9780198758785.003.0047","url":null,"abstract":"The right gastroepiploic artery (RGEA) conduit is the only other in situ arterial graft available for use in coronary artery bypass graft surgery other than the internal thoracic artery. Total arterial revascularization using only pedicled grafts can be achieved using the RGEA in combination with the bilateral internal thoracic artery in three-vessel disease. Early graft patency rate is high and the late patency rate is excellent when the RGEA is harvested by the skeletonized technique and deployed to target coronary arteries with severe stenosis (>90%). Abdominal complications are rare since only a small laparotomy is required. Late graft disease is uncommon in the RGEA conduit. At repeat coronary artery bypass graft surgery involving solely the right coronary artery territory, a small laparotomy approach using the RGEA can be performed with an off-pump technique without sternotomy. The RGEA conduit also can be used as a free or composite graft if the RGEA had low free flow, or if intraoperative flow measurement suggested a competitive flow pattern.","PeriodicalId":199690,"journal":{"name":"State of the Art Surgical Coronary Revascularization","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128631530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiac computed tomography 心脏计算机断层扫描
State of the Art Surgical Coronary Revascularization Pub Date : 2021-01-01 DOI: 10.1093/MED/9780198758785.003.0013
S. Liao
{"title":"Cardiac computed tomography","authors":"S. Liao","doi":"10.1093/MED/9780198758785.003.0013","DOIUrl":"https://doi.org/10.1093/MED/9780198758785.003.0013","url":null,"abstract":"Rapid technological advances have allowed for the application of computed tomography imaging for the evaluation of the heart. Cardiac computed tomography scanning is now a standard method to investigate the anatomical structure of the heart and, most commonly, the coronary vasculature, given the prevalence of coronary artery disease and its associated morbidity and mortality. Due to the heart’s constant motion and the relatively small luminal diameters of the coronary arteries, scanning the heart and coronaries by computed tomography presents unique challenges for image acquisition normally not encountered when imaging other anatomical areas.","PeriodicalId":199690,"journal":{"name":"State of the Art Surgical Coronary Revascularization","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116746651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Composite grafts 复合移植
State of the Art Surgical Coronary Revascularization Pub Date : 2021-01-01 DOI: 10.1093/med/9780198758785.003.0056
J. Tatoulis, B. Buxton
{"title":"Composite grafts","authors":"J. Tatoulis, B. Buxton","doi":"10.1093/med/9780198758785.003.0056","DOIUrl":"https://doi.org/10.1093/med/9780198758785.003.0056","url":null,"abstract":"Composite grafts should be within the repertoire of every coronary surgeon. Validated in the early 1990s, they are used to accomplish multiple or total arterial revascularization, which achieves the best coronary revascularization results, either with two internal thoracic arteries or by a combination of an internal thoracic artery and a radial artery.","PeriodicalId":199690,"journal":{"name":"State of the Art Surgical Coronary Revascularization","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121535795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Total arterial revascularization 全动脉血运重建
State of the Art Surgical Coronary Revascularization Pub Date : 2021-01-01 DOI: 10.1093/MED/9780198758785.003.0048
B. Yanagawa, D. Taggart, J. Puskas
{"title":"Total arterial revascularization","authors":"B. Yanagawa, D. Taggart, J. Puskas","doi":"10.1093/MED/9780198758785.003.0048","DOIUrl":"https://doi.org/10.1093/MED/9780198758785.003.0048","url":null,"abstract":"The superiority of coronary artery bypass grafting with a single internal thoracic artery and saphenous vein grafts over percutaneous coronary intervention has been demonstrated in large, multicentre randomized controlled trials, particularly for patients with diabetes and complex coronary disease. Long-term graft patency is critical to the benefit that coronary artery bypass grafting provides, since graft failure begets recurrent angina, need for repeat intervention, myocardial infarction and diminished survival. Saphenous vein grafts have significant rates of early and late graft failure.","PeriodicalId":199690,"journal":{"name":"State of the Art Surgical Coronary Revascularization","volume":"133 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126706482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Angiography 血管造影术
State of the Art Surgical Coronary Revascularization Pub Date : 2021-01-01 DOI: 10.1093/med/9780198758785.003.0015
Matthew I Tomey
{"title":"Angiography","authors":"Matthew I Tomey","doi":"10.1093/med/9780198758785.003.0015","DOIUrl":"https://doi.org/10.1093/med/9780198758785.003.0015","url":null,"abstract":"‘As an aid to diagnosis in ischaemic heart-disease’, Lancet editorialists wrote in 1966, coronary angiography ‘seems at present to offer little that cannot be more easily obtained by much simpler methods, such as good history-taking and electrocardiography’. Since its serendipitous origins at the Cleveland Clinic laboratory of Dr F. Mason Sones in 1958, selective coronary angiography has taken on central importance in the diagnosis of coronary artery disease and characterization of coronary anatomy prior to coronary artery bypass graft surgery. Performance has become simpler and safer, evolving from a brachial artery cut-down approach with stiff, large-calibre multipurpose catheters to percutaneous femoral, radial, and now ulnar approaches with softer, lower-profile catheters specially designed to atraumatically engage the coronary ostia.","PeriodicalId":199690,"journal":{"name":"State of the Art Surgical Coronary Revascularization","volume":"81 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123981143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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