Аннотация
Заболевания клапанов сердца представляют собой серьезную проблему. Причиной их возникновения обычно являются дегенеративные и атеросклеротические изменения, врожденные аномалии или ревматический процесс. Открытое протезирование аортального клапана остается «золотым» стандартом в лечении пациентов с тяжелым стенозом аорты и аортальной регургитацией. Гомотрансплантаты аорты были первыми успешными биологическими протезами без каркаса, которые использовались для лечения патологий аортального клапана в начале 1960-х годов. Низкая доступность и cложная техника имплантации ограничивали их использование, поэтому импульс к развитию получило применение ксенотрансплантатов и методик использования аутоперикарда. Выбор бескаркасных биопротезов последнего поколения дает возможность получить низкие транспротезные градиенты и имплантировать протезы большего размера пациентам с несоответствием «пациент-протез». В то же время использование методики доктора Ozaki позволяет получить почти нативный клапан даже при деформации фиброзного кольца и нивелировать процесс отторжения ксеноткани, вследствие чего этот метод стал весьма перспективным для решения множества задач в современной хирургии. В данном обзоре представлены современные результаты использования этих методик с описанием хирургической техники и показаний.
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Об авторах
- Ибрагимов Магомед Сайгидахмедович, аспирант; ORCID
- Асатрян Тигран Владимирович, канд. мед. наук, науч. сотр., ORCID
- Скопин Иван Иванович, д-р мед. наук, профессор, заведующий отделением,
директор Института коронарной и сосудистой хирургии; ORCID
