复杂冠心病血运重建策略内外科专家共识.pdf

中国循环杂志 2022 年 11 月 第 37 卷 第 11 期（总第 293 期）Chinese Circulation Journal，November，2022，Vol. 37 No.11（Serial No.293） 1073 指南与共识 复杂冠心病血运重建策略内外科专家共识 复杂冠心病血运重建心脏团队决策研究协作组 摘要 复杂冠心病（包括冠状动脉多支病变和左主干病变 ）患者病变复杂、合并症多，血运重建是其主要治疗方式。目 前常见的血运重建方式有经皮冠状动脉介入治疗和冠状动脉旁路移植术。两种技术不断进展，适应证不断更新。指 南推荐由多学科心脏团队共同制定最佳血运重建策略，但仍存在决策灰区，且内外科专家之间存在技术认知盲区。 本专家共识系统阐述了复杂冠心病血运重建策略高质量临床研究证据、内外科技术进展、心脏团队规范化流程并做 出推荐，以期促进复杂冠心病最佳血运重建决策的制定。 关键词 复杂冠心病；血运重建证据；技术进展；心脏团队；共识 Expert Consensus on Revascularization for Complex Coronary Artery Disease The Task Force for the Heart Team Research on Complex Coronary Artery Disease Revascularization. Co-corresponding Authors: ZHENG Zhe, Email: zhengzhe@; DOU Kefei, Email: drdoukefei@126.com Abstract Patients with complex coronary artery disease (CAD), including left main disease and multi-vessel disease, often have complex coronary anatomy and multiple comorbidities. Revascularization (including percutaneous coronary intervention [PCI] and coronary artery bypass grafting [CABG]) is the main treatment method for these patients. With the continuous development of techniques and technologies, the indications for PCI/CABG have been constantly updated. Guidelines recommend a heart team for the decision making of the optimal myocardial revascularization strategies for complex CAD, but several uncertain indications still exist. In addition, there is a technical knowledge gap between cardiologists and cardiac surgeons. The present expert consensus comprehensively elaborates the high-quality clinical research evidence on complex CAD revascularization, the progress of PCI and CABG techniques, and the standardized process of the heart team, and makes recommendations based on the available evidence, aiming to improve the decision making of optimal revascularization for patients with complex CAD. Key words complex coronary artery dis