Ghép động mạch vú trong trái (BITA) so với ghép động mạch vú đơn

Current Cardiology Reports - Tập 20 - Trang 1-7 - 2018
Michael Persson1,2, Ulrik Sartipy1,2
1Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
2Section of Cardiothoracic Surgery, Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden

Tóm tắt

Trong những năm gần đây, đã có nhiều tiến bộ trong việc cải thiện kết quả cho bệnh nhân mắc bệnh động mạch vành. Một trong những chủ đề được tranh luận nhiều nhất liên quan đến điều trị phẫu thuật bằng ghép mạch vành (CABG) là lựa chọn mạch ghép. Bài tổng quan này nhằm trình bày tình trạng hiện tại và bằng chứng khoa học cho việc sử dụng ghép động mạch vú trong trái (BITA). Các nghiên cứu quan sát và phân tích gộp cho thấy việc sử dụng BITA có liên quan đến tỷ lệ sống sót tốt hơn. Kết quả ban đầu từ một thử nghiệm ngẫu nhiên có đối chứng quy mô lớn cho thấy tính an toàn và hiệu quả của phương pháp. Tỷ lệ sống sót được cải thiện có thể tăng thêm ở những nhóm bệnh nhân được chọn lọc, nhưng đồng nghĩa với sự gia tăng các biến chứng liên quan đến vết thương xương ức. Lợi ích của việc sử dụng mạch ghép BITA dường như tồn tại cho đến độ tuổi khoảng 69 năm tại thời điểm phẫu thuật. CABG với ghép BITA có khả năng liên quan đến tỷ lệ sống sót lâu dài tốt hơn nhưng cũng làm tăng nguy cơ nhiễm trùng vết thương xương ức. Kết quả sau 10 năm từ Thử nghiệm Tái thông mạch động mạch dự kiến sẽ có vào năm 2018, cung cấp bằng chứng tốt nhất về phương pháp này cho đến nay. Kết quả ban đầu cho thấy đây là một phương pháp an toàn đối với hầu hết các danh mục bệnh nhân phù hợp với CABG.

Từ khóa

#ghép mạch vành #động mạch vú trong trái #CABG #bệnh động mạch vành #biến chứng phẫu thuật

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