Tổng quan: Hướng dẫn Nhật Bản về tái tưới máu cơ tim để điều trị bệnh tim thiếu máu ổn định 2012

General Thoracic and Cardiovascular Surgery - Tập 61 - Trang 246-253 - 2012
Masami Ochi1
1Department of Cardiovascular Surgery, Nippon Medical School Graduate School of Medicine, Tokyo, Japan

Tóm tắt

Kể từ khi được giới thiệu vào đầu những năm 1970, phẫu thuật bắc cầu động mạch vành (CABG) đã trở thành một phương pháp điều trị phẫu thuật quen thuộc cho bệnh động mạch vành (CAD). Can thiệp mạch vành qua da (PCI), được ứng dụng lâm sàng lần đầu tiên vào năm 1977, đã được quảng bá như một sự thay thế cho CABG trong giữa những năm 1980. Cùng với sự mở rộng trên toàn quốc của PCI, tỷ lệ PCI so với CABG đã vượt quá 6–7:1. Hội Tim mạch Nhật Bản (JCS) đã công bố “Hướng dẫn về can thiệp động mạch vành theo yêu cầu, bao gồm cả phẫu thuật bắc cầu động mạch vành (CABG), cho bệnh tim thiếu máu cục bộ vào năm 2000” và “Hướng dẫn về việc lựa chọn ống dẫn bắc cầu và các thủ tục phẫu thuật trong phẫu thuật bắc cầu động mạch vành cho bệnh tim thiếu máu cục bộ”. Hội đã dự định sửa đổi các hướng dẫn này vào năm 2010 và phát hành hai hướng dẫn mới cụ thể cho PCI hoặc CABG. Họ cũng lên kế hoạch phát hành hướng dẫn chung cho tái tưới máu cơ tim và PCI/CABG, những chỉ định chính cho bệnh nhân có CAD ổn định, đặc biệt là những bệnh nhân có bệnh lý thân chung bên trái phức tạp hơn và/hoặc bệnh lý đa mạch. Ủy ban khoa học của JCS đã thành lập “Hội đồng về tái tưới máu cơ tim” bao gồm các chuyên gia bao gồm bác sĩ tim mạch can thiệp và không can thiệp, bác sĩ phẫu thuật tim và các bác sĩ chuyên khoa về tiểu đường hoặc thận được lựa chọn bởi các hội y tế và phẫu thuật. Sau hơn 10 vòng họp, Hội đồng đã chuẩn bị các hướng dẫn cơ bản cho tái tưới máu cơ tim để điều trị CAD ổn định, PCI/CABG. Các hướng dẫn này bao gồm (1) Các phát biểu về tái tưới máu cơ tim, (2) Giải thích các phát biểu và (3) Chỉ định cho PCI/CABG bao gồm một bảng.

Từ khóa

#tái tưới máu cơ tim #phẫu thuật bắc cầu động mạch vành #can thiệp mạch vành qua da #bệnh tim thiếu máu cục bộ #chỉ định điều trị

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