Roberto Ferrari 意大利Ferrara大学Anna医院心血管研究中心主任
《国际循环》:您曾提到过年轻人的冠心病,那么目前年轻患者的现状如何?应该如何管理这些患者?
<International Circulation>: With especially the myocardial revascularization guidelines developed together with the EACTS, is this idea of teamwork and the ‘heart team’ one of the more important things to have emerged from those guidelines?
《国际循环》:特别是随着与EACTS一起发展的心肌血管重建术指南,团队合作和“心脏团队”的重要理念是从指南中衍生出来的么?
Prof Ferrari: Theoretically yes, but as I said, not everyone can have the luxury of having a heart team. Not every hospital has a cardiac surgeon. Even in my hospital for example, there is no cardiac surgery. We refer patients to a nearby hospital (only thirty kilometers away) for surgery. The surgeon visits to discuss the cases twice a week. If we do a coronary angiogram, for example, and an angioplasty can be done, we try to do it immediately rather than wait for the surgeon to discuss it. So theoretically we should work as a team but it is not always possible. However, I believe that more and more cardiologists are acting on reflex – they see an occlusion and they dilate it. This is wrong. One needs to stop a moment and think about the cost benefit, whether a drug would be more appropriate and so on. This is common sense.
Ferrari教授:理论上可以这样说,但正如我说的,不是每一个人都能够享有心脏团队。也不是每个医院都拥有心脏外科医生。例如即使在我的医院,也没有心脏外科手术。我们将病人转到附近的医院(30公里以外)进行手术。外科医生每两周例行会诊并讨论病例。如果我们做了冠脉造影,比如说可以实施血管成形术,我们会尝试立即这样做,而不是等到外科医生来讨论后。所以理论上我们应作为一个团队工作,但实际上并不是总能实现的。然而,我相信越来越多的心脏专家会条件反射性的采取这样的做法,一旦看到血管闭塞就去实施扩张。这种做法是错误的,我们需要停下来考虑下成本效益,药物治疗是否更合适等等。这些都是常识。