Аннотация
Увеличение объема левого желудочка после инфаркта миокарда является ключевым компонентом патологического процесса ремоделирования, приводящего к дисфункции левого желудочка, сердечной недостаточности и неблагоприятному прогнозу отдаленной выживаемости. Стратегия лечения должна быть направлена на восстановление геометрии (ре-ремоделирование) левого желудочка, коррекцию коронарного кровоснабжения с помощью эндоваскулярного и/или хирургического вмешательств на фоне адьювантной терапии. Целью геометрической реконструкции в сочетании с реваскуляризацией миокарда в первую очередь является уменьшение камеры левого желудочка путем резекции рубцовой ткани, особенно у пациентов с преобладанием симптомов сердечной недостаточности, а также у больных с рубцовым поражением миокарда при умеренных процессах ремоделирования. В настоящем обзоре изложены патогенез постинфарктной аневризмы, обоснование и современные методы реконструкции и восстановления функции левого желудочка, а также показания к проведению хирургического вмешательства, в основу которых положен многолетний мировой опыт.
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Об авторах
- Калов Астемир Ризуанович, аспирант, orcid.org/0000-0002-0231-4420
- Коваленко Олег Александрович, доктор мед. наук, вед. науч. cотр., orcid.org/0000-0003-4485-3964
