Хірургічна реваскуляризація міокарда при стабільній ішемічній хворобі серця. Quo vadis?
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Анотація
У статті проаналізовано сучасні дані про роль операції аортокоронарного шунтування (АКШ) у пацієнтів зі стабільною ішемічною хворобою серця. Наведено принципи передопераційної оцінки ризику та вибору між АКШ і перкутанним коронарним втручанням. На підставі результатів контрольованих досліджень визначено показання для операції АКШ в узгоджених рекомендаціях. Оцінка життєздатності міокарда та коронарного резерву дає можливість покращити відбір пацієнтів для реваскуляризаційних втручань. З позицій доказової медицини розглянуто предиктори ранніх післяопераційних ускладнень та результати тривалого спостереження за пацієнтами, які перенесли АКШ. Можливими проміжними критеріями ефективності реваскуляризації є зміни насосної функції лівого шлуночка та показники якості життя. Окрему увагу приділено перспективам використання нових хірургічних технологій для покращення результатів АКШ.
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