Хірургічна реваскуляризація міокарда при стабільній ішемічній хворобі серця. Quo vadis?

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O. A. Yepanchintseva
O. J. Zharinov
B. M. Todurov

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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Ключові слова:

Стабільна ішемічна хвороба серця, аортокоронарне шунтування, показання, ускладнення, ефективність

Посилання

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