ОДНОМОМЕНТНАЯ ХИРУРГИЧЕСКАЯ КОРРЕКЦИЯ ПРИ СОЧЕТАННОМ ПОРАЖЕНИИ СОННЫХ И КОРОНАРНЫХ АРТЕРИЙ

Работа выполнена с целью определения эффективного и безопасного подхода к лечению пациентов с сочетанными патологиями сонных и коронарных артерий.

В период с 2006 по 2016 г. в ГУ РНПЦ «Кардиология» было прооперированно 207 пациентов c сочетанными патологиями сонных и коронарных артерий. Клинические данные пациентов включали: стенокардию напряжения функционального класса III, хроническую сердечную недостаточность NYHA III, одно- или двустороннее поражение внутренней сонной артерии, хроническую артериальную недостаточность нижних конечностей, сахарный диабет, хроническую болезнь почек. При выявлении конкурирующей патологии сонных и коронарных артерий пациентам выполняли одномоментную коррекцию для снижения количества периоперационных осложнений и во избежание летальности (каротидную эндартерэктомию сочетали с операцией на сердце), а при наличии соответствующих показаний аортокоронарное шунтирование дополняли коррекцией клапанного аппарата и/или пластикой аневризмы левого желудочка.

Анализ результатов хирургической коррекции патологий коронарных и сонных артерий при сочетанном их поражении показал безопасность и эффективность применяемого тактического подхода. Летальность и послеоперационные осложнения не превышали аналогичные показатели у пациентов, прооперированных только по поводу ишемической болезни сердца (летальность 2,9 %).

Таким образом, получен положительный результат при использовании данной тактики в лечении пациентов с ишемической болезнью и патологией сонной артерии.

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