Аннотация
Атеросклеротическое поражение коронарных и брахиоцефальных артерий (БЦА) нередко составляет
сопутствующую патологию у пациентов — кандидатов на хирургическую коррекцию клапанного аппарата
сердца и могут быть причиной таких периоперационных осложнений, как инфаркт миокарда
и/или инсульт. Тактика хирургического лечения сочетанных поражений сонных и коронарных артерий
(каротидной эндартерэктомии и коронарного шунтирования) разработана и широко представлена
в литературе. В то же время стратегия комплексного вмешательства на клапанах сердца, сонных
артериях и коронарных сосудах остается недостаточно изученной и представляет значительный научный
и практический интерес по следующим направлениям: предоперационная диагностика основного
заболевания и сочетанной патологии, включая скрининговое ультразвуковое дуплексное сканирование
БЦА, а также определение тактических подходов в выполнении хирургического лечения на
основании установленных факторов хирургического риска. Кроме того, в последние годы в литературе
широко обсуждаются вопросы реваскуляризации сонных артерий с помощью эндоваскулярных
методов, являющихся менее инвазивными, то есть альтернативой, и характеризующихся меньшей частотой
развития инсульта. Цель публикации — представить системный обзор вопросов оптимизации
тактических подходов хирургического лечения пациентов с пороками клапанов сердца и сопутствующим
атеросклеротическим поражением брахиоцефальных и коронарных артерий.
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Об авторах
- Суеркулов Бекназар Алымжанович, врач — сердечно-сосудистый хирург, orcid.org/0000-0002-5207-5763;
- Асатрян Тигран Владимирович, канд. мед. наук, науч. сотр., orcid.org/0000-0002-0141-5481