INTERNATIONAL CIRCULATION:How do you think about the Percutaneous Coronary Intervention(PCI) on left main artery disease?
《国际循环》：您对经皮冠状动脉内介入治疗（PCI）处理左主干病变有什么看法？

PROF.RICHARD CONTI:Yes I can comment on that.I have some feelings that may be we should not done it on everybody， that is forsure. It should be done in patients who have protected left main coronary artery， mainly bypass into the other artery.But itis not done as often， in people with only left main disease. I must say if they have some reasons for not having surgery， I will do PCI first. But it is very rare， yes， you can do it， but the risk is high. If you make a mistake， it will kill the patient， the patient will die.It is not some yes or do it on everybody practice.
Prof.Richard Conti:我可以为此发表一些看法。我认为目前我们不应该在每个病人身上尝试PCI。在有保护的左主干中我们可以尝试。在没有保护的左主干病变，PCI并不是常规的方法。但如果病人因为其他原因不适合进行搭桥手术时，我会尝试PCI。可是这种情况非常少见。这样做的风险很高，一旦出差错，病人就会死亡。所以这不是每个病人都可以承受的医疗常规。

INTERNATIONAL CIRCULATION:There is a trend in China that many intervention cardiologists try PCI first on patients who have multi-vessel disease， is it a common practice in US too?
《国际循环》：目前在中国，许多心血管介入医生在有多支血管病变的患者身上进行冠状动脉介入手术，请问在美国也存在类似的做法吗？

PROF.RICHARD CONTI:I think so， In general， if somebody has ideal disease， a proximal disease in one coronary artery and good distal flow， that the first attempt should be PCI stent. But if you have six to seven vessels involved， that is too many， that they should go to coronary surgery， in my opinion. If you have two vessels are involved， e.g proximal LAD， proximal right， you give priority to PCI. In general， it gets very good results， even the cardiac surgeon will do that， they will have their PCI first， there is no question about it. The heart surgery is still very good and very safe. But it is surgery， it takes more out of the patient， takes more time to recovery. It takes two or three months， although it works fine. So in my patients， in general， I will try PCI first.
Prof.Richard Conti:我认为是。通常假如一个病人血管条件非常理想，比如单支血管近段病变，远段血流又很好时，我们应该首先尝试介入手术。但假如有六、七根血管受累，当然这已经很多了，我认为这些病人应该去搭桥。假如有两支血管受累，如左前降支近段、右冠状动脉近段，应该优先考虑PCI，外科医生们也会这样考虑。目前外科手术效果非常好，而且非常安全。但毕竟是外科手术，对患者的损伤比较大，恢复时间也比较长，即使手术效果很好，一般也需要两到三个月时间。所以对我的病人，我也会首先考虑介入手术。

INTERNATIONAL CIRCULATION:In China Doc Hu Dayi is advocating the concept that cardiac surgeon and intervention cardiologist should work hand in hand， and share the same cardiac department. What is your opinion about that?
《国际循环》：在中国，胡大一教授在大力倡导心脏外科医生和心脏介入医生应该共同协作，在医院内成立心脏内外科联合病房。您对此有什么看法？

PROF.RICHARD CONTI:I am totally agree on that， but what we need to do is have surgeon and intervention cardiologist see what is best therapy for the patient. In my instituition， our surgeons feel the same way. If the best therapy for the patients is PCI， let us do it. Or now I think there can be a risk， let us go to the heart surgery. If many of our interventional people say this is too risky for PCI， we will go to the surgery. So the idea here is to get what is best for the patients. Besides that all these people need medical therapy， it is not just PCI or surgery， there is background of blood pressure control， diabetes control， lipid control，no smoking， etc. That has to be done and I will work it through， no matter what.
Prof.Richard Conti:我非常赞成这样的做法。我们需要让外科医生和介入医生认识到什么是患者最佳治疗方案？在我所在的医院，我们的外科医生也是这样想的。如果最佳方案是冠状动脉介入手术，我们就去做介入手术。如果我们觉得介入手术有风险，我们就做外科手术。所以主要的问题是患者最佳治疗策略的制定。此外，这些患者除了需要介入或外科手术以外，均需要其他系列性治疗，如控制血压、控制血糖、调节血脂、戒烟等。这些问题都需要进行干预，所以不管怎样，我同样会努力解决这些问题。

INTERNATIONAL CIRCULATION:Is IABP(Intra Aortic Balloon counterPulsation) widely used in US?
《国际循环》：主动脉内气囊反搏（IABP）技术在美国的应用现状是怎样的？

PROF.RICHARD CONTI:First of all，it is a very wonderful treatment ，but its main reason for use is cardiogenic shock. It is not without problems， because many of these people that we use it on have bad aorta， coronary diseases， carotid disease， etc.This thing goes into this areas.You know，the balloon is 30-40cm long and 2-4cm wide when it is opened up.So it can do damage， but it also can save people’s lives too. I don’t like to use it just bacause the patient has the risk. I use it if the patient has the problem， I don’t use it to prevent outcome. Because you can not predict. When you use it on some patients， you put them at the risk of technique without knowing whether it will do any good or not.
Prof.Richard Conti:首先，这是一项非常杰出的治疗方法，但主要用在心脏性休克的患者身上。这项技术并不是完美无缺。因为在我们的病人身上出现过一些问题，如主动脉损伤，冠状动脉损伤，颈动脉的问题等。这些都属于它并存的问题。我们知道，气囊充气时长度到30-40 cm，宽度到2-3cm，所以它可能会损伤血管，但同时可以拯救病人生命。我不喜欢仅仅因为患者存在风险而用气囊反搏，相反我会在有问题的患者身上使用。我不会为了避免严重后果而使用这个技术，因为你不可能预测哪个患者会出现问题。当你在某个病人身上预防性应用时，你将他置于该项技术的风险中，而并不知道这是否会给病人带来益处。

INTERNATIONAL CIRCULATION:You have been a editor in chief of Clinical Cardiology for many years， can you give us some advice on how to get papers published in your journal or English journals?Can you recommend some journals to send manuscript?
《国际循环》：我们知道您多年来担任“临床心脏病学“（Clinical Cardiology）杂志的主编。您能否给我们提供一些有关如何在您的杂志或其他英文杂志上发表文章方面的建议？此外，能否推荐一些好的心血管专业杂志？

PROF.RICHARD CONTI:First of all， you have to get good data or good idea. The majority of Chinese can not write English properly. That does not means they have not good data， the only problem they have is good expression. As an editor in chief， I can recognize the good data and go back to rewrite it in proper English.I have reviewer to overview manuscripts， that will upset them， they can not read them and give bad review， that is real limitation. So I advise anybody in China， if your English is not something that you feel comfortable with， get someone who is good at to read the manuscript and rewrite sentences. Don’t change the data a lot， just rewrite the presentation， that helps a lot.You know， good data get published， bad data do not get published. If you write it in proper English， proper syntaxis， it will help you a lot. Because it is not easy to get things published.There are a lot journals， but there are a lot of people writing papers too. In my journal， the acceptance rate is no more than 20-25%， in some journals it is 10%， in some journals，it is single digit. But the JACC， Circulation， AHJ are al