References

kpccz

Комплексные проблемы сердечно-сосудистых заболеваний

Complex Issues of Cardiovascular Diseases

2306-12782587-9537

Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”

10.17802/2306-1278-2019-8-1-100-111

kpccz-535

Research Article

АНАЛИТИЧЕСКИЙ ОБЗОР

ANALYTICAL REVIEW

МЕХАНИЧЕСКАЯ ПОДДЕРЖКА КРОВООБРАЩЕНИЯ ПРИ ЧРЕСКОЖНОМ КОРОНАРНОМ ВМЕШАТЕЛЬСТВЕ

MECHANICAL CIRCULATORY SUPPORT IN PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION

https://orcid.org/0000-0003-1389-8414

Гречишкин

А. А.

Grechishkin

A. A.

врач отделения рентгенохирургических методов диагностики и лечения,

улица 1 Мая, 167, Краснодар, 350086

MD, physician at the Endovascular Surgery Department,

167, 1 Maya St., Krasnodar, 350086

surgeon205@mail.ru

https://orcid.org/0000-0002-6749-5197

Майнгарт

С. В.

Mayngart

S. V.

врач отделения рентгенохирургических методов диагностики и лечения,

улица 1 Мая, 167, Краснодар, 350086

MD, physician at the Endovascular Surgery Department,

167, 1 Maya St., Krasnodar, 350086

https://orcid.org/0000-0003-0439-8389

Некрасов

А. С.

Nekrasov

A. S.

врач отделения рентгенохирургических методов диагностики и лечения,

улица 1 Мая, 167, Краснодар, 350086

MD, physician at the Endovascular Surgery Department,

167, 1 Maya St., Krasnodar, 350086

https://orcid.org/0000-0001-5589-2040

Федорченко

А. Н.

Fedorchenko

A. N.

доктор медицинских наук, заведующий отделением рентгенохирургических методов диагностики и лечения,

улица 1 Мая, 167, Краснодар, 350086

PhD, Head of the Endovascular Surgery Department,

167, 1 Maya St., Krasnodar, 350086

Порханов

В. А.

Porhanov

V. A.

доктор медицинских наук, академик РАН, профессор, главный врач больницы,

улица 1 Мая, 167, Краснодар, 350086

PhD, Academician of RAS, Professor, Medical Director,

167, 1 Maya St., Krasnodar, 350086

Государственное бюджетное учреждение здравоохранения «Научно-исследовательский институт – Краевая клиническая больница №1 им. профессора С.В. Очаповского» Министерства здравоохранения Краснодарского краяРоссияState Budget Public Health Institution “Scientific Research Institution — S.V. Ochapovsky Regional Clinic Hospital №1”, Public Health Ministry of Krasnodar RegionRussian Federation

2019

29032019

81100111

2019

Гречишкин А.А., Майнгарт С.В., Некрасов А.С., Федорченко А.Н., Порханов В.А.

Grechishkin A.A., Mayngart S.V., Nekrasov A.S., Fedorchenko A.N., Porhanov V.A.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.nii-kpssz.com/jour/article/view/535

Несмотря на стремительное развитие эндоваскулярной хирургии, смертность при чрескожном коронарном вмешательстве (ЧКВ) у пациентов с высокими рисками тяжелых кардиальных осложнений и в критических состояниях (кардиогенный шок, остановка сердечной деятельности) остается крайне высокой. Успех ЧКВ напрямую зависит от способности «кардиокоманды» предотвращать и своевременно купировать тяжелые нарушения сердечной деятельности. На данный момент фармакологическая терапия не способна полноценно бороться с развитием тяжелых кардиальных событий при проведении ЧКВ. Именно поэтому в таких ситуациях использование устройств чрескожной механической поддержки кровообращения (ЧМПК) может оказать неоценимую помощь при лечении данной категории пациентов. Несмотря на то, что в течение нескольких десятилетий устройства ЧМПК используются для стабилизации пациентов при кардиогенном шоке и обеспечения гемодинамической поддержки при ЧКВ высокого риска, результаты их применения остаются неоднозначными. Целью настоящей статьи является обзор современных устройств ЧМПК, имеющихся данных и результатов исследований, показаний для их применения, а также практических моментов их эксплуатации, которые могут помочь в принятии правильного решения по выбору устройств ЧМПК.

Despite the rapid evolution in the development of endovascular surgery, the mortality of patients undergoing percutaneous coronary interventions (PCI) with high risk of severe cardiac complications and critical conditions (cardiogenic shock, cardiac arrest) remains extremely high. The success of PCI directly depends on the ability of the Heart Team to prevent and timely eliminate severe cardiac disorders. Despite the rapid evolution in the development of endovascular surgery, the mortality of patients undergoing percutaneous coronary interventions (PCI) with high risk of severe cardiac complications and critical conditions (cardiogenic shock, cardiac arrest) remains extremely high. The success of PCI directly depends on the ability of the Heart Team to prevent and timely eliminate severe cardiac disorders. Pharmacological therapy is not able to completely resist the development of severe cardiac events during PCI. In such situations the usage of devices for percutaneous mechanical circulation support (PMCS) can make an invaluable help in the treatment of this group of patients. Despite the fact that the PMCS devices are used to stabilize patients with cardiogenic shock and to provide hemodynamic support for high-risk PCI for several decades, the results of their application remain ambiguous. The purpose of this article is to review all existing literature on modern PMCS devices, available data and research results, indications for their use, and operational considerations that can ensure the decision-making process in selecting optimal PMCS devices.

механическая поддержка кровообращенияЧКВкардиогенный шок

mechanical circulatory supportPCIcardiogenic shock

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The authors declare that there are no conflicts of interest present.