<International Circulation>: Treatment option for left main and multivessel coronary artery desease has been a hot topic for many years， the landmark SYNTAX study have provided significant implications， would you please summarize the major principle to which we should adhere when making the choice between CABG and PCI for patients with left main and multi-vessel coronary artery desease?

  《国际循环》：很多年来，左主干和多支血管冠状动脉病变的治疗选择一直是热点话题。里程碑式的SYNTAX试验提供了重大启示。能否请您概括一下，对左主干和多支血管冠状动脉病变患者选择CABG或PCI治疗时应遵循的主要原则有哪些？

    Dr. Eeckhout: This is a very pertinent question. The congress with again highlight this in the session on left main vascularization this afternoon. We have new vascularization guidelines that have been out now for about two years which have been made at the level of the European Society between surgeons and cardiologists and represents a common statement by these specialities. These guidelines clearly state that if you have a patients with multi-vessel disease and left main disease that you have to approach this patient in the team approach. This means that cardiologists and surgeons must sit together and look at the clinical picture of the patient， looking at the angiogram， and decide together what is the best therapeutic option for the patient. Another point is that the guidelines， for the first time， leave a window open for PCI in these patients. I would say that the previous guidelines mentioned that all these patients needed surgery， so things have changed based on the results of SYNTAX. The other point is that we now have the SYNTAX score， which is an angiographic score with the higher the score， the more complex the anatomy and the more the patient will benefit from surgical intervention.  So with this I think we have clear guidance now in that the decision can be made very early and relatively easily.

    Eeckhout博士：这是一个非常中肯的问题。大会将在今天下午的左主干血运重建论坛上再次强调这一点。我们有新的血运重建指南，至今已经发布了约有两年，它是外科医生和心脏病医生联合在欧洲学会的水平上制定的，代表了这些专业的共同声明。这些指南明确规定，如果你有一例罹患多支血管病变和左主干病变的患者，你必须以团队的方式来着手处理这例患者。这意味着，心脏病医生和外科医生必须坐在一起，审视患者的临床表现，看看血管造影照片，并一起决定患者的最佳治疗选择是什么。另一点是，在这些患者中，指南首次为PCI留下了一扇窗。我想说的是，既往指南提到过所有这些患者都需要手术治疗，因此基于SYNTAX的结果，情况已经发生了变化。另一点是，我们现在有SYNTAX评分，这是一种血管造影评分，评分越高，解剖越复杂则患者从外科干预中将受益越多。所以，有鉴于此，我认为我们现在有明确的指导，在这种情况下，可以很早且相对容易地作出决定。