References

vtio

Вестник трансплантологии и искусственных органов

Russian Journal of Transplantology and Artificial Organs

1995-1191

Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation

10.15825/1995-1191-2009-4-30-39

vtio-265

Research Article

Трансплантомика

Transplantomics

АЛЬТЕРНАТИВНЫЙ МЕТОД ХИРУРГИЧЕСКОЙ КОРРЕКЦИИ РАССЛАИВАЮЩИХ АНЕВРИЗМ АОРТЫ В СОЧЕТАНИИ С АОРТАЛЬНОЙ НЕДОСТАТОЧНОСТЬЮ

ALTERNATIVE METHOD OF SURGICAL CORRECTION OF DISSECTING AORTIC ANEURYSMS WITH AORTIC INSUFFIECIENCY

Семеновский

М. Л.

Semenovsky

M. L.

Акопов

Г. А.

Akopov

G. A.

akopov@mail.ru

ФГУ «Федеральный научный центр трансплантологии и искусственных органов им. академика В.И. Шумакова» Минздравсоцразвития РФ, МоскваРоссияAcademician V.I. Shumakov Federal Research Center of Transplantology and Artificial Organs, MoscowRussian Federation

2009

03062014

114

ВЕСТНИК ТРАНСПЛАНТОЛОГИИ И ИСКУССТВЕННЫХ ОРГАНОВ том XI No 4–2009

3039

2009

Семеновский М.Л., Акопов Г.А.

Semenovsky M.L., Akopov G.A.

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/265

Пациенты с расслаивающей аневризмой аорты с сопутствующей аортальной недостаточностью состав- ляют группу тяжелых больных с выраженной сердечной недостаточностью и, как правило, заинтересо- ванностью других органов и систем. В связи с этим оправданным является стремление снизить риск опе- рации благодаря использованию более щадящих методик, в частности супракоронарного протезирования восходящей аорты с реконструкцией ее корня. Такого типа операции в ФНЦТиИО выполняют с 1996 года. За период с 1996-го по 2009 год 27 пациентам с расслаивающей аневризмой аорты и недостаточностью аортального клапана, средний возраст которых составил 54,5 ± 2,1 года, было выполнено супракоро- нарное протезирование аорты. Основным этиологическим фактором был атеросклероз – 89%. 17 (63%) пациентов имели I тип, 6 (22,2%) – IIA тип и 4 (14,8%) – II тип расслоения. Помимо супракоронарного протезирования аорты в 4 случаях потребовалось полное протезирование дуги аорты, в 13 – частичное. Общая госпитальная летальность составила 11%.

Patients with dissecting aortic aneurysm and associated acute aortic insufficiency form a group of seriously ill patients with significant cardiac failure, generally involving other organs and systems. It justifies an attempt to reduce a surgical risk, by using more sparing procedures, including supracoronary replacement of the ascending aorta with its root reconstruction. The latter has been performed in 27 patients (mean 54,5 ± 2,1 years) with dissecting aortic aneurysm and aortic valvular insufficiency in 1996 to 2009. The major etiological factor was atherosclerosis (88%)/ Seventeen (63%), 6 (22,2%) and 4 (16%) had types I, IIA and II dissection, respectively. Overall hospital mortality was 11%. In late period, progressive aneurysm dissection needed reinterventions in 2 cases. The competence of the reconstructed aortic valve was satisfactory both just after surgery and throughout the follow-up. Indications for this option of chronic correction, surgical techniques, and immediate and long-term results are outlined.

расслаивающая аневризма аортыаортальная недостаточностьсупракоронарное протезирование аорты

dissecting aortic aneurysmaortic insufficiencysupracoronary replacement of the ascending aorta

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