DOI: 10.25881/BPNMSC.2019.37.36.021

Авторы

Гурьев В.В., Зверев Д.А., Стрелков Д.А., Кучеренко В.С.

ФГБУ «Национальный медицинский исследовательский центр им. В.А. Алмазова» Минздрава России, Санкт-Петербург

Аннотация

Вторичный дефект межпредсердной перегородки (ДМПП) относится к одному из наиболее распространённых врождённых пороков сердца (ВПС), клиническая картина которого обусловлена шунтированием крови между системным и лёгочным кровотоками. Если дефект оставить без коррекции, то с возрастом, существующая объёмная перегрузки сердца, приводит к различным кардиальным осложнениям и ранней, по сравнению со здоровыми людьми, смертности. Транскатетерные и хирургические методы коррекции ДМПП показывают схожие результаты, но, тем не менее, транскатетерное закрытие дефекта более предпочтительно, особенно, в группе взрослых и пожилых пациентов. Коррекция дефекта показана всем пациентам с гемодинамически значимым шунтом на уровне межпредсердной перегородки (МПП), вне зависимости от возраста и симптомов, за исключением пациентов с сопутствующей тяжёлой или необратимой лёгочной гипертензией. Клиническая симптоматика и выживаемость находятся в обратной зависимости от возраста пациента, степени лёгочной гипертензии и времени коррекции порока. В статье предложен к рассмотрению алгоритм отбора и ведения взрослых пациентов с вторичным ДМПП.

Ключевые слова: вторичный дефект межпредсердной перегородки, сердечная недостаточность, лёгочная гипертензия, нарушения ритма, транскатетерная коррекция, хирургическое лечение.

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