vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2021-2-52-59vtio-1329Research ArticleЗаместительная почечная терапияCARDIOVASCULAR ASPECTS OF TRANSPLANT SURGERYНепосредственные результаты лечения тяжелого кальциноза фиброзного кольца митрального клапанаImmediate outcomes of treatment of severe mitral annular calcificationМуратовР. М.MuratovR. M.

Муратов Равиль Муратович, заведующий отделением неотложной хирургии приобретенных пороков сердца

Москва

Moscow

sorcommn@gmail.comСоркомовМ. Н.SorcomovM. N.

Соркомов Максим Нюргустанович, врач сердечно-сосудистый хирург отделения неотложной хирургии приобретенных пороков сердца

121552, Москва, Рублевское ш., д. 135

Maxim N. Sorcomov

135, Rublevskoye sh., Moscow, 121552

sorcommn@gmail.comСачковА. С.SachkovA. S.

Москва

Moscow

sorcommn@gmail.comБабенкоС. И.BabenkoS. I.

Бабенко Светлана Ивановна, ведущий научный сотрудник отделения неотложной хирургии приобретенных пороков сердца

Москва

 

Moscow

sorcommn@gmail.comСлепцоваА. М.SleptsovaA. M.

Москва

Moscow

ТереховМ. И.TerekhovM. I.

Москва

Moscow

ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии имени А.Н. Бакулева» Минздрава РоссииРоссияBakulev Scientific Center for Cardiovascular SurgeryRussian Federation2021090620212325259Copyright © Муратов Р.М., Соркомов М.Н., Сачков А.С., Бабенко С.И., Слепцова А.М., Терехов М.И., 20212021Муратов Р.М., Соркомов М.Н., Сачков А.С., Бабенко С.И., Слепцова А.М., Терехов М.И.Muratov R.M., Sorcomov M.N., Sachkov A.S., Babenko S.I., Sleptsova A.M., Terekhov M.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/1329

Кальциноз митрального кольца (КМК) – хронический дегенеративный процесс с вовлечением фиброзной части митрального комплекса, характеризующийся отложением кальция, потерей функции клапана. Распространенность КМК составляет 8–10%, но несмотря на ее распространенность, клиническая значимость КМК недооценена. В настоящее время имеются сообщения, что полная декальцинация приводит к улучшению отдаленных результатов у больных с тяжелым КМК. Выполнен анализ непосредственных результатов операций на митральном клапане у больных с тяжелым кальцинозом митрального кольца с декальцинацией. Кальцинированное фиброзное кольцо подверглось во всех случаях полной декальцинации, отложения кальция удалялись единым блоком, в 6 случаях реконструировано ксеноперикардиальной заплатой, в 2 случаях выполнено ушивание фиброзного кольца. Два случая госпитальной смертности, причиной у одной больной послужила острая сердечная недостаточность на 8-е сутки, у второй – ТЭЛА на 30‑е сутки после операции. Осложнений, связанных с травмированием коронарной артерии, разрывом задней стенки левого желудочка не было. Опыт лечения тяжелого кальциноза митрального клапана с обширной декальцинацией фиброзного кольца и последующей реконструкцией дает удовлетворительный результат.

Mitral annular calcification (MAC) is a chronic degenerative process involving the fibrous part of the mitral complex, characterized by calcium deposition and loss of valve function. MAC prevalence is 8–10%, but despite this, the clinical significance of MAC is underestimated. Currently, there are reports that complete decalcification leads to improved long-term outcomes in patients with severe MAC. An analysis of the immediate outcomes of mitral valve surgery in patients with severely calcified mitral annulus with decalcification was performed. The calcified annulus fibrosus underwent complete decalcification in all cases. Calcium deposits were removed in a single block, in 6 cases it was reconstructed with a xeno-pericardial patch; in 2 cases the annulus fibrosus was sutured. There were 2 cases of in-hospital mortality, caused by acute heart failure on day 8 in 1 patient and pulmonary embolism on day 30 after operation in the second patient. There were no complications associated with coronary artery injury and left ventricular posterior wall rupture. Experience in the treatment of severe mitral valve calcification with extensive annulus fibrosus decalcification and subsequent reconstruction is possible and gives satisfactory results.

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The authors declare that there are no conflicts of interest present.