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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La revascularizaci&#243;n completa con injertos arteriales pretende garantizar una perfusi&#243;n duradera de todas las arterias coronarias enfermas para minimizar la recurrencia de la isquemia mioc&#225;rdica&#46; Esta estrategia resulta t&#233;cnicamente factible en la mayor&#237;a de los pacientes con enf&#176;medad multivaso utilizando una o dos arterias mamarias en combinaci&#243;n con la arteria radial o la gastroepiploica&#44; ya sea como conductos simples&#44; secuenciales o compuestos&#46; Sin embargo&#44; hay pacientes en los que no todos estos conductos pueden o deben utilizarse&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La revascularizaci&#243;n arterial puede realizarse tanto con circulaci&#243;n extracorp&#243;rea como sin ella&#46; Es un procedimiento t&#233;cnicamente m&#225;s exigente y prolonga el tiempo quir&#250;rgico&#46; Sin embargo&#44; con suficiente experiencia&#44; puede llevarse a cabo con una mortalidad y una incidencia de complicaciones mayores similar a la de la cirug&#237;a coronaria convencional&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Aunque la capacidad de flujo de los conductos arteriales es suficiente en la mayor&#237;a de los casos&#44; hay evidencias que sugieren que aumenta el riesgo de isquemia residual&#44; especialmente en el postoperatorio inmediato y cuando se utilizan injertos compuestos&#46; Tampoco est&#225; claro que la permeabilidad de algunos conductos arteriales distintos a la arteria mamaria sea claramente mejor que la de la vena safena en todos los supuestos anat&#243;micos&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Aunque muchas publicaciones avalan la seguridad y eficacia de la revascularizaci&#243;n arterial completa&#44; no se dispone todav&#237;a de informaci&#243;n concluyente que demuestre los beneficios cl&#237;nicos a largo plazo en todos los tipos de pacientes&#46; Son necesarios estudios prospectivos a gran escala para conocer los resultados a largo plazo y aclarar definitivamente sus indicaciones&#46;</p>"
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        "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Complete arterial revascularization pretends to provide a durable perfusion of all the ischemic myocardium to minimize the recurrence of ischemia&#46; This surgical strategy is technically feasible in most of the patients with multi-vessel disease using one or two mammary arteries in combination with the radial or the gastroepiploic arteries&#44; either as simple&#44; sequential or composite grafts&#46; Nevertheless&#44; there are conditions that preclude the use of some of these conduits in certain groups of patients&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Complete arterial revascularization can be carried out both with extracorporeal circulation or off-pump&#46; It is technically more demanding than conventional coronary surgery and prolongs surgical time&#46; However&#44; with enough experience&#44; it can be carried out with both a mortality and a incidence of complications similar to that of the conventional surgery&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The flow capacity of the arterial conduits is enough to meet the myocardial demands in most of the cases&#46; However&#44; some evidences suggest that it increases the risk of residual ischemia&#44; especially early after the operation and whenever composite arterial grafts are used&#46; Neither it is clear that the patency of some arterial conduits other than the mammary artery is better than that of saphenous vein in all the anatomical situations&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Although many publications endorse the security and effectiveness of the complete arterial revascularization&#44; conclusive information demonstrating long-term clinical benefits in all the types of patients is still lacking&#46; Large scale prospective studies are necessary to know the long-term resultsof complete arterial revascularization and to clarify the indications of this strategy definitively&#46;</p>"
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