Coronary heart disease surgery in “hybrid” mode

  Coronary heart disease (CHD), has long been a threat to human health. With its increasing incidence in China, how to effectively treat coronary heart disease has become the focus of clinical discussion and research.  Coronary heart disease is not simple Coronary heart disease may not be a heart problem but a vascular problem in the early stages of its development. For example, when blood lipids are persistently high, the viscosity of blood in the arteries increases, which tends to leave residual scale on the vessel walls and is the cause of atherosclerosis from the heterogeneity of the vessel walls. The serious consequence of coronary atherosclerosis is myocardial dystrophy.  Why is myocardial dystrophy a serious consequence of coronary atherosclerosis?  Under normal circumstances, the coronary arteries have a smooth blood flow and abundant capacity, which can fully bear the energy demand of the heart contracting and beating day and night. However, when the coronary arteries are narrowed or even blocked, the pressure in the blood vessels increases and the blood flow is restricted, once the degree of ischemia breaks through the heart’s tolerance limit, the heart will issue ischemic warnings such as “angina” and “heart attack”. This means that if the narrowing or blockage of the coronary arteries is not repaired in time, it is likely to cause irreversible damage to the heart and even life-threatening.  ”Drug therapy, interventional therapy and surgery are the three common clinical treatments for coronary heart disease.  Medication is the most basic method for treating coronary heart disease, and it is used throughout the whole treatment process. Even if patients choose interventional therapy or surgery, they still need to control various risk factors and complications of coronary heart disease through medication. Bypass surgery is one of the most important ways to reconstruct blood flow by bypassing the stenosis of coronary arteries and building a new pathway, which has an irreplaceable role in improving patients’ myocardial ischemia in the long term, but the risk of open-heart surgery and cardiac arrest is always a problem for clinicians and patients. However, the risks associated with open-heart surgery and cardiac arrest have always been a problem for clinicians and patients.  Each method has its own specific patient population, and the simpler the patient’s condition, the easier the treatment will be, but although coronary artery disease is common, it is not simple, and patients with coronary artery disease are often clinically seen to be multi-diseased and complex.  In the practice of coronary artery disease treatment, we found that interventional procedures and surgical procedures do not conflict with each other, and if they are properly coordinated, they can often achieve complementary and mutually beneficial effects. For example, theoretically, bypass surgery is the most appropriate treatment when all three coronary vessels are diseased, but for elderly patients or those with kidney disease, diabetes and other complications, bypass surgery itself is another high-risk factor. Surgical treatment, the patient’s physique can not bear the risk, interventional treatment, and can not achieve the three vessels at the same time, then the emerging mode of coronary artery disease hybrid surgery can come in handy. On the one hand, it can be done in a surgical site that is easy to operate, while also avoiding the risks and complications associated with cardiac arrest, and the risks of surgery can be minimized, and the patient gets the maximum benefit at the same time.  The use of hybrid surgery in the clinical treatment of cardiovascular disease is increasing, both for physicians and patients, and this multidisciplinary model can indeed solve many limitations that cannot be overcome unilaterally with half the effort, and at the same time, the more complex the disease, the more diverse treatment ideas and tools are needed to seek breakthroughs. Of course, the rise of the hybridization model does not mean that the original treatment will be replaced, as previously mentioned, each treatment method has its special target patient population, so the clinical treatment is still symptomatic, the appropriate is the best.