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  • 2017 №2
  • Cовременное состояние проблемы хирургического лечения обструктивной гипертрофической кардиомиопатии

Cовременное состояние проблемы хирургического лечения обструктивной гипертрофической кардиомиопатии

В.О. Одинцов ГУ РНПЦ «Кардиология»
2017 №2 | Лекции
Аннотация
Список литературы
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Данная статья содержит развёрнутый литературный обзор вариантов хирургической коррекции одной из наиболее распространенных форм первичных кардиомиопатий – гипертрофической кардиомиопатии. Оперативное лечение обструктивных форм этого заболевания продолжает представлять значимую медико-социальную проблему. Хирургические методы всё более активно практикуются специалистами, но зачастую решения, принимаемые перед вмешательством, носят противоречивый характер. Наличие и применение на сегодняшний день многочисленных и различных инвазивных методик лечения уже не новой патологии, свидетельствует о том, что в данном направлении кардиохирургии есть еще место научным изысканиям с целью улучшения результатов лечения. Выбор оптимальной лечебной стратегии и тактики по-прежнему остаётся предметом для обсуждения. Целью данного обзора является систематизация и сравнительный анализ наиболее значимых исследований, посвящённых применению основных хирургических и альтернативных неконсервативных методик лечения обструктивной гипертрофической кардиомиопатии. Описаны преимущества и недостатки тех или иных способов, пристальное внимание уделено сравнительной эффективности миосептэктомии и транскатетерной септальной аблации, а также вопросу о спорной роли митрального протезирования в коррекции данной патологии.
Ключевые слова:
миосептэктомия, митральное протезирование, транскатетерная спиртовая септальная аблация, передне-систолическое движение митрального клапана
The problem of hypertrophic obstructive cardiomyopathy surgical treatment: current state

This article contains a detailed literary review of surgical correction options for one of the most common forms of primary cardiomyopathies – hypertrophic cardiomyopathy. Surgical treatment of obstructive forms of this disease continues to represent a significant medical and social problem. Surgical methods are more and more actively used by practitioners, but often a decision making before the intervention is controversial. The wide using of many various invasive treatment methods today of not a new kind of disease, suggests that in this area of cardiac surgery there is still a place for a further scientific research in aim to improve treatment outcomes. Selection of the optimal surgical strategy and tactics still remains a matter for debate. The aim of this review is the systematization and comparative analysis of the most significant studies, dedicated to usage of basic surgical procedures and alternative non-conservative interventions in treatment of hypertrophic obstructive cardiomyopathy. The advantages and disadvantages of various methods are described. Close attention is paid to the comparative effectiveness of septal myectomy and transcatheter septal ablation, as well as on the controversial role of the mitral prosthesis in correction of this pathology.

Keywords
septal myectomy, mitral prosthesis, transcatheter septal ablation, systolic anterior motion of the mitral valve
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