АОРТАЛЬНЫЙ СТЕНОЗ, ДИАГНОСТИКА, ТАКТИКА ЛЕЧЕНИЯ. ЧТО ВАЖНО ЗНАТЬ ТЕРАПЕВТУ?

Аортальный стеноз является самым частым проявлением клапанной болезни сердца, который требует хирургического или эндоваскулярного вмешательства. Распространенность дегенеративного аортального стеноза увеличивается из-за старения населения. Клиническое течение аортального стеноза характеризуется длительно существующим бессимптомным периодом. Прогрессирующая кальцификация створок клапана приводит к формированию градиента давления в аорте, гемодинамической перегрузке левого желудочка, развитию гипертрофии миокарда, способствующей нарушению диастолической функции левого желудочка. После появления симптомов аортального стеноза двухгодичная выживаемость у пациентов, которым не проводится хирургическая коррекция, не превышает 50 %. В Рекомендациях Европейской ассоциации кардиологов и Европейской ассоциации кардиоторакальных хирургов по лечению пациентов с клапанной болезнью сердца 2017 г. обсуждаются аспекты диагностики аортального стеноза и принципов выбора тактики ведения пациентов с использованием хирургического или катетерного методов лечения. Могут быть рекомендованы хирургическое протезирование аортального клапана или его транскатетерная имплантация. Применение медикаментозной терапии аортального стеноза не показало возможности улучшения прогноза.

клапанная болезнь сердца, аортальный стеноз, диагностика, лечение

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