Preview

Московский хирургический журнал

Расширенный поиск

CLINICAL CASE OF MULTIDISCIPLINARY APPROACH TO TREATMENT OF ANEURYSM OF THE AORTIC ROOT, ASCENDING AND INFRARENAL AORTA

https://doi.org/10.17238/issn2072-3180.2021.1.118-123

Полный текст:

Аннотация

One of the most difficult and rapidly developing areas of cardiovascular surgery is aortic surgery. In recent years, surgery of the combined pathology of the aorta has been actively developing, as well as reconstructive surgery of the aortic root and aortic valve. Today in case of ascending aorta aneurysm with aortic insufficiency and the absence of morphological changes of aortic valve leaflets, surgeons try to make the different types of Valve-Preserving Surgery. The progress achieved in endovascular treatments for aortic pathology has made it possible to reduce surgical mortality and improve long-term results of the abdominal aortic aneurysms treatment.
In our clinical case taking into account the general severity of the patient's condition and the high risks of simultaneous surgery, the tactics of two-stage surgical treatment was chosen. The first stage is the ascending aorta prosthetics with preservation of the native valve, the second stage is endovascular treatment of the infrarenal aorta.
Conclusion. This work demonstrates the successful clinical experience of a multidisciplinary approach to two-stage treatment of a patient with root and ascending aortic aneurysm with aortic valve insufficiency and infrarenal aortic aneurysm.

Об авторах

D. V. Shumakov
Department of Cardiac Surgery Moscow Regional Research and Clinical Institute named after M.F. Vladimirskii (MONIKI)
Россия

Shumakov Dmitry Valerievich, MD, PhD, professor, corresponding member RAS, Head

Schepkina str., 61/2, Moscow, 129110



D. I. Zybin
Department of Cardiac Surgery Moscow Regional Research and Clinical Institute named after M.F. Vladimirskii (MONIKI)
Россия

Zybin Dmitry Igorevich, MD, PhD

Schepkina str., 61/2, Moscow, 129110



A. V. Vaschenko
Department of Cardiac Surgery Moscow Regional Research and Clinical Institute named after M.F. Vladimirskii (MONIKI)
Россия

Vashchenko Anton Vasilievich, MD, PhD, Department head of the Angiography

Schepkina str., 61/2, Moscow, 129110



R. N. Larkov
Department of Cardiac Surgery Moscow Regional Research and Clinical Institute named after M.F. Vladimirskii (MONIKI)
Россия

Larkov Roman Nikolaevich, Doctor of Chemistry, Department head of the Vascular surgery and CHD

Schepkina str., 61/2, Moscow, 129110



E. G. Agafonov
Department of Cardiac Surgery Moscow Regional Research and Clinical Institute named after M.F. Vladimirskii (MONIKI)
Россия

Agafonov Ievgeniy Gennadevich, MD, Researcher

Schepkina str., 61/2, Moscow, 129110



M. A. Popov
Department of Cardiac Surgery Moscow Regional Research and Clinical Institute named after M.F. Vladimirskii (MONIKI)
Россия

Popov Mikhail Alexandrovich, MD, Researcher

Schepkina str., 61/2, Moscow, 129110



V. V. Dontsov
Department of Cardiac Surgery Moscow Regional Research and Clinical Institute named after M.F. Vladimirskii (MONIKI)
Россия

Dontsov Vladislav Viktorovich, MD, Researcher

Schepkina str., 61/2, Moscow, 129110



Список литературы

1. Komarov R., Karavaykin P., Murylev V. History of reconstructive surgery of aorta and aortic valve. Circulation Pathology and Cardiac Surgery, 2017, No. 21 (3S), рр. 45–60. http://dx.doi.org/10.21688/1681-3472-2017-3S-45-60

2. David T., Ivanov J., Armstrong S., Feindel C., Webb G. Aortic valvesparing operations in patients with aneurysms of the aortic root or ascending aorta. Ann Thorac Surg., 2002, Nov; No. 74 (5), рр. 1758–1761https://doi.org/10.1016/S0003-4975(02)04135-8

3. Birks E.J., Webb C., Child A., Radley-Smith R., Yacoub M.H. Early and long-term results of a valve-sparing operation for Marfan syndrome. Circulatio, 1999, No. 100 (19 Suppl.), рр. II29–II35. https://doi.org/10.1161/01.cir.100.suppl_2.ii-29

4. David T.E. Remodeling the aortic root and preservation of the native aortic valve. Oper. Tech. Card. Thorac. Surg., 1996, No. 1 (1), рр. 44–56. https://doi.org/10.1016/S1085-5637(07)70080-3

5. David T.E., Armstrong S., Maganti M., Colman J., Bradley T.J. Longterm results of aortic valve-sparing operations in patients with Marfan syndrome. J. Thorac. Cardiovasc. Surg., 2009, No. 138 (4), рр. 859–864. https://doi.org/10.1016/j.jtcvs.2009.06.014

6. De Oliveira N.C., David T.E., Ivanov J., Armstrong S., Eriksson M.J., Rakowski H., Webb G. Results of surgery for aortic root aneurysm in patients with Marfan syndrome. J. Thorac. Cardiovasc. Surg., 2003, No. 125 (4), рр. 789–796. https://doi.org/10.1016/S1010-7940(00)00379-1

7. David T.E., David C.M., Feindel C.M., Manlhiot C. Reimplantation of the aortic valve at 20 years. J. Thorac. Cardiovasc. Surg., 2017, No. 153, рр. 232–238. https://doi.org/10.1016/j.jtcvs.2016.10.081

8. Hirsch A.T., Haskal Z.J., Hertzer N.R. et al. ACC/AHA 2005 practice guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery. Circulation, 2006, No. 113, рр. 463–654. https://doi.org/10.1161/Circulationaha.106.174526

9. Perreas K., Samanidis G., Michalis A. et al.Outcomes after ascending aorta and proximal aortic arch repair using deep hypothermic circulatory arrest with retrograde cerebral perfusion: analysis of 207 patients. Interact Cardiovasc Thorac Surg., 2012, № 15, рр. 456 – 461. https://doi.org/10.1093/icvts/ivs252


Для цитирования:


Shumakov D.V., Zybin D.I., Vaschenko A.V., Larkov R.N., Agafonov E.G., Popov M.A., Dontsov V.V. CLINICAL CASE OF MULTIDISCIPLINARY APPROACH TO TREATMENT OF ANEURYSM OF THE AORTIC ROOT, ASCENDING AND INFRARENAL AORTA. Московский хирургический журнал. 2021;(1):118-123. https://doi.org/10.17238/issn2072-3180.2021.1.118-123

Просмотров: 14


Creative Commons License
Контент доступен под лицензией Creative Commons Attribution 4.0 License.


ISSN 2072-3180 (Print)