kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”10.17802/2306-1278-2023-12-2-122-137kpccz-1262Research ArticleАНАЛИТИЧЕСКИЙ ОБЗОР. Сердечно-сосудистая хирургияREVIEWS. Cardiovascular surgeryОТДАЛЕННЫЕ ГЕМОДИНАМИЧЕСКИЕ ИСХОДЫ ВМЕШАТЕЛЬСТВ НА АОРТАЛЬНОМ КЛАПАНЕ: ОБЗОР СРАВНИТЕЛЬНЫХ ИССЛЕДОВАНИЙLONG-TERM HEMODYNAMIC OUTCOMES OF DIFFERENT AORTIC VALVE INTERVENTIONS – A REVIEW OF COMPARATIVE STUDIEShttps://orcid.org/0000-0002-3904-6415КомаровРоман НиколаевичKomarovRoman N.

доктор медицинских наук, профессор заведующий кафедрой сердечно-сосудистой хирургии института профессионального образования, директор клиники факультетской хирургии им. Н.Н. Бурденко федерального государственного автономного образовательного учреждения высшего образования Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет), Москва, Российская Федерация

PhD, Professor, Head of the Department of Cardiovascular Surgery, Institute of Professional Education, Director Advanced Surgery Clinic named after N.N. Burdenko, Federal State Autonomous Educational Institution of Higher Education “I.M. Sechenov First Moscow State Medical University” of the Ministry of Health of the Russian Federation, Moscow, Russian Federation

alisher77786@bk.ruhttps://orcid.org/0000-0002-8246-3708БадалянСамсон СергеевичBadalyanSamson S.

аспирант федерального государственного автономного образовательного учреждения высшего образования Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет), Москва, Российская Федерация

Postgraduate Student, Federal State Autonomous Educational Institution of Higher Education “I.M. Sechenov First Moscow State Medical University” of the Ministry of Health of the Russian Federation, Moscow, Russian Federation

alisher77786@bk.ruhttps://orcid.org/0000-0002-1564-9182ЧернявскийСтанислав ВячеславовичChernyavskyStanislav V.

кандидат медицинских наук врач – сердечно-сосудистый хирург, заведующий кардиохирургическим отделением клиники факультетской хирургии им. Н.Н. Бурденко университетской клинической больницы № 1 федерального государственного автономного образовательного учреждения высшего образования Первый Московский государственный медицинский университет имени И.М. Сеченова министерства здравоохранения Российской Федерации (Сеченовский Университет), Москва, Российская Федерация

PhD, Cardiovascular Surgeon, Head of the Cardiac Surgery Department, Advanced Surgery Clinic named after N.N. Burdenko, University Clinical Hospital No. 1, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation

alisher77786@bk.ruhttps://orcid.org/0000-0001-8545-3276ИсмаилбаевАлишер МаккамджановичIsmailbayevAlisher M.

кандидат медицинских наук врач – сердечно-сосудистый хирург, доцент кафедры факультетской хирургии № 1 института клинической медицины им. Н.В. Склифосовского федерального государственного автономного образовательного учреждения высшего образования Первый Московский государственный медицинский университет имени И.М. Сеченова министерства здравоохранения Российской Федерации (Сеченовский Университет), Москва, Российская Федерация

PhD, Cardiovascular Surgeon, Associate Professor at the Department of Faculty Surgery No. 1, Institute of Clinical Medicine named after N.V. Sklifosovsky, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation

alisher77786@bk.ruhttps://orcid.org/0000-0002-8376-3104ЭнгиноевСослан ТайсумовичEnginoyevSoslan T.

кандидат медицинских наук, доцент кафедры сердечно-сосудистой хирургии факультета последипломного образования федерального государственного бюджетного образовательного учреждения высшего образования «Астраханский государственный медицинский университет» Министерства здравоохранения Российской Федерации, Астрахань, Российская Федерация

PhD, Associate Professor at the Department of Cardiovascular Surgery, Federal State Budgetary Educational Institution of Higher Education “Astrakhan State Medical University” of the Ministry of Health of the Russian Federation, Astrakhan, Russian Federation

alisher77786@bk.ruhttps://orcid.org/0000-0002-3895-0832МукановаМаруар БатыровнаMukanovaMaruar B.

аспирант кафедры факультетской хирургии № 1 института клинической медицины им. Н.В. Склифосовского федерального государственного автономного образовательного учреждения высшего образования Первый Московский государственный медицинский университет имени И.М. Сеченова министерства здравоохранения Российской Федерации (Сеченовский Университет), Москва, Российская Федерация

Postgraduate Student, Department of Advanced Surgery No. 1, Institute of Clinical Medicine named after N.V. Sklifosovsky, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation

alisher77786@bk.ruhttps://orcid.org/0000-0002-6226-2984ГафуровФуркатджон СобирджоновичGafurovFurkatdzhon S.

кандидат медицинских наук руководитель регионального сосудистого центра государственного бюджетного учреждения здравоохранения Московской области «Егорьевская центральная районная больница», Егорьевск, Московская область, Российская Федерация

PhD, Head of the Regional Vascular Center, State Budgetary Healthcare Institution of the Moscow Region “Yegoryevskaya Central District Hospital”, Yegoryevsk, Moscow Region, Russian Federation

alisher77786@bk.ruhttps://orcid.org/0000-0002-8740-9575БабакуловаНаргиза МустафаевнаBabakulovaNargiza M.

врач ультразвуковой диагностики кардиохирургического отделения клиники факультетской хирургии им. Н.Н. Бурденко университетской клинической больницы № 1 федерального государственного автономного образовательного учреждения высшего образования Первый Московский государственный медицинский университет имени И.М. Сеченова министерства здравоохранения Российской Федерации (Сеченовский Университет), Москва, Российская Федерация

Ultrasound Diagnostics Specialist at the Cardiac Surgery Department Advanced Surgery Clinic named after N.N. Burdenko, University Clinical Hospital No. 1, Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation

alisher77786@bk.ruhttps://orcid.org/0009-0000-8898-5702ОвусуРичмондOwusuRichmond

аспирант федерального государственного автономного образовательного учреждения высшего образования Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет), Москва, Российская Федерация

Postgraduate Student, Federal State Autonomous Educational Institution of Higher Education “I.M. Sechenov First Moscow State Medical University” of the Ministry of Health of the Russian Federation, Moscow, Russian Federation

alisher77786@bk.ruФедеральное государственное автономное образовательное учреждение высшего образования Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияFederal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)Russian FederationФедеральное государственное бюджетное образовательное учреждение высшего образования «Астраханский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияFederal State Budgetary Educational Institution of Higher Education “Astrakhan State Medical University” of the Ministry of Health of the Russian FederationRussian FederationГосударственное бюджетное учреждение здравоохранения Московской области «Егорьевская центральная районная больница»РоссияState Budgetary Healthcare Institution of the Moscow Region “Yegoryevskaya Central District Hospital”Russian Federation202325062023122122137Copyright © Комаров Р.Н., Бадалян С.С., Чернявский С.В., Исмаилбаев А.М., Энгиноев С.Т., Муканова М.Б., Гафуров Ф.С., Бабакулова Н.М., Овусу Р., 20232023Комаров Р.Н., Бадалян С.С., Чернявский С.В., Исмаилбаев А.М., Энгиноев С.Т., Муканова М.Б., Гафуров Ф.С., Бабакулова Н.М., Овусу Р.Komarov R.N., Badalyan S.S., Chernyavsky S.V., Ismailbayev A.M., Enginoyev S.T., Mukanova M.B., Gafurov F.S., Babakulova N.M., Owusu R.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/1262Основные положения

Основные положения

 

 

Резюме

Резюме

В мировой литературе по-прежнему недостаточно отражены данные, посвященные сравнительному анализу эхокардиографических исходов, в частности состояния левого желудочка, в отдаленные сроки после различных вмешательств на аортальном клапане. В представленном обзоре проанализированы современные литературные данные (публикации за последние 20 лет), направленные на оценку эхокардиографических исходов различных вмешательств на аортальном клапане. Стратегия поиска включала использование международных научных баз данных и библиотек – Scopus, Web of Science, PubMed и Cochrane. Ключевыми словами поиска служили aortic valve surgery, long term period, echocardiographic outcomes. В анализ вошли сравнительные рандомизированные, проспективные или ретроспективные исследования. Сравнение механического и биологического типов протезирования продемонстрировало, что механическое протезирование, наряду с доказанной долговечностью, не уступает, а иногда и превосходит биопротезирование в отношении транспротезной гемодинамики и динамики обратного ремоделирования ЛЖ. При анализе пиковых трансклапанных градиентов и эффективной площади отверстия аортального клапана очевидное преимущество определено в когорте бескаркасных протезов. В большинстве рандомизированных клинических испытаний продемонстрированы значительные гемодинамические преимущества процедуры Росса в сравнении с другими методами протезирования аортального клапана, а увеличение числа участников (за счет будущих испытаний) может показать еще большую статистическую значимость. В мировой литературе нами обнаружена единственная работа, в которой сопоставлены среднеотдаленные гемодинамические исходы аутоперикардиальной неокуспидизации аортального клапана с другими типами имплантации. При среднем периоде наблюдения 426±270 дня в группе аутоперикардиальной неокуспидизации зафиксированы значительно более низкий средний градиент давления и более высокая эффективная площадь отверстия. Несмотря на видимые гемодинамические преимущества транскатетерной имплантации аортального клапана в среднеотдаленные сроки, результаты мониторинга значимой резидуальной аортальной регургитации представляются сомнительными.

Highlights

Highlights

 

 

Abstract

Abstract

Currently, there are not enough data on the comparative analysis of echocardiographic outcomes, especially in regards to the state of the left ventricle in the long term after different aortic valve interventions. In this review, we present up-to-date literature data (publications published over 20 years) concerning echocardiographic outcomes after different aortic valve replacements. For the search of publications, the authors used international databases such as Scopus, Web of Science, Pubmed and Cochrane. The search keywords were: “aortic valve surgery”, “long-term period”, “echocardiographic outcomes”, “quality of life”. The analysis includes only comparative randomized, prospective or retrospective studies. A comparison between mechanical and biological prostheses has demonstrated that mechanical valves, in addition to displaying higher durability, can be advantageous in certain situations to bioprostheses in relation to transvalvular hemodynamics and reverse left ventricle remodeling. Regarding the comparison of stentless and stented bioprostheses with respect to peak transvalvular gradients and the effective orifice area, an obvious advantage was observed in the stentless bioprosthesis group. The majority of randomized clinical trials have showed great hemodynamic advantages of the Ross procedure in comparison with other types of aortic valve replacement, and an increase in the number of participants (due to future trials) may demonstrate even greater statistical significance. We have found only one publication that presents data on the comparison of the mid-term hemodynamic outcomes of neocuspidization of the aortic valve using autologous pericardium with other types of interventions. With an average follow-up period of 426±270 days, a significantly lower average pressure gradient and a higher effective orifice area were recorded in the neocuspidization group. Despite hemodynamic benefits of transcatheter aortic valve replacement in the mid-term period after surgery, the results of postoperative monitoring show significant residual aortic regurgitation, which is highly undesirable.

Хирургия аортального клапанаГемодинамические исходыОтдаленный периодAortic valve surgeryHemodynamic outcomesLong-term periodАвторы заявляют об отсутствии финансирования исследования.ReferencesКомаров Р. Н., Чернявский С. В., Исмаилбаев А. М., Симонян А. О. Аутоперикардиальная неокуспидизация аортального клапана: как это делать?. Патология кровообращения и кардиохирургия. 2021;25(1):120-127. doi:10.21688/1681-3472-2021-1-120-127Комаров Р. Н., Чернявский С. В., Исмаилбаев А. М., Симонян А. О. Аутоперикардиальная неокуспидизация аортального клапана: как это делать?. Патология кровообращения и кардиохирургия. 2021;25(1):120-127. doi:10.21688/1681-3472-2021-1-120-127Stocco F., Fabozzo A., Bagozzi L., Cavalli C., Tarzia V., D'Onofrio A., Lorenzoni G., Chiminazzo V., Gregori D., Gerosa G. Biological versus mechanical aortic valve replacement in non-elderly patients: a single-centre analysis of clinical outcomes and quality of life. 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The authors declare that there are no conflicts of interest present.