冠脉闭塞病变：保守？介入相关治疗_周旭晨.ppt

冠脉闭塞病变：保守？介入治疗？;CTO病变：慢性完全闭塞性病变 (Chronic Total Coronary Occlusions );;冠心病病人的病态平衡;临床表现 1支CTO病变(侧枝循环好/差) LAD:心绞痛/左心功能不全 LCX,RCA优势:无症状/不稳定心绞痛 LCX,RCA非优势:无症状/症状不典型 10年生存率90% ;1支CTO的危险性:冠脉造影常见模式 LAD(CTO)+ RCA(Donated Artery)新病变 Or vise versa： 严重的左心功能受损,A-V Block,心脏骤停 LAD(CTO)+LCX(Donated Artery)新病变 Or vise versa： 严重的左心功能不全, A-V Block,心脏骤停 RCA(CTO)+LCX (Donated Artery)新病变 Or vise versa： 严重的右心功能不全, A-V Block,心脏骤停;;CTO病变：慢性完全闭塞性病变 (Chronic Total Coronary Occlusions );CTO病变：慢性完全闭塞性病变 (Chronic Total Coronary Occlusions );CTO病变：慢性完全闭塞性病变 (Chronic Total Coronary Occlusions );CTO病变：慢性完全闭塞性病变 (Chronic Total Coronary Occlusions );CTO病变：慢性完全闭塞性病变 (Chronic Total Coronary Occlusions );CTO病变：慢性完全闭塞性病变 (Chronic Total Coronary Occlusions );CTO病变：慢性完全闭塞性病变 (Chronic Total Coronary Occlusions );CTO病变：慢性完全闭塞性病变 (Chronic Total Coronary Occlusions );CTO病变：慢性完全闭塞性病变 (Chronic Total Coronary Occlusions );CTO病变：慢性完全闭塞性病变 (Chronic Total Coronary Occlusions );CTO病变：慢性完全闭塞性病变 (Chronic Total Coronary Occlusions );CTO病变：慢性完全闭塞性病变 (Chronic Total Coronary Occlusions );CTO病变：慢性完全闭塞性病变 (Chronic Total Coronary Occlusions );“一个不能少!”; Dr Hochman lamented. I tried to get more than 217 sites, but many major medical centers wouldnt participate because they didnt want to leave the artery closed. She emphasized that the results of OAT do not apply to patients in the acute phase of MI, who are known to benefit from early reperfusion, or those with unstable disease. ;These results challenge the long-standing belief that opening a blocked artery is always good. Instead, the study suggests that late angioplasty is unnecessary in this circumstance. The good news is there have been tremendous advances in drug therapy for heart attack patients. Drug therapy is an important treatment option. ;但,临床实际出现这样的结果怎么办?…;经介入医生的手,转危为安;LAD;我军主力部队;开通CTO病变的临床意义;Thank You for Your Attention!