ORTTIRILGAN YURAK NUQSONLARIDA CHAP BO‘LMACHA ATRIOMEGALIYASINI JARROHLIK YO‘LI BILAN DAVOLASH NATIJALARINI BAHOLASH
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orttirilgan yurak nuqsonlariAbstrak
Ushbu tadqiqot orttirilgan mitral qopqoq nuqsonlari bilan kechuvchi chap boʻlmacha atriomegaliyasida atrioplastika usullarining klinik va gemodinamik samaradorligini baholashga bagʻishlangan. Tadqiqotga orttirilgan yurak qopqoq nuqsonlari bilan operatsiya qilingan 138 nafar bemor kiritildi. Shundan 108 nafar bemorda chap boʻlmacha atriomegaliyasi mavjud boʻlib, ular Kawazoe va Mercedes atrioplastikasi bajarilgan guruhlarga ajratildi, 30 nafar bemor esa nazorat guruhini tashkil etdi. Barcha bemorlarda klinik, elektrokardiografik, rentgenologik va exokardiografik tekshiruvlar amalga oshirildi hamda operatsiyadan oldingi va keyingi natijalar qiyosiy baholandi. Tadqiqot natijalari atrioplastika chap boʻlmacha hajmini ishonchli kamaytirishini, chap qorincha funksiyasi va intrakardial gemodinamikani yaxshilashini, oʻpka arteriyasidagi bosimni pasaytirishini hamda sinus ritmining tiklanish chastotasini sezilarli oshirishini koʻrsatdi. Kawazoe usulida chap boʻlmacha diametri 8,2±1,9 sm dan 5,1±1,1 sm gacha, Mercedes usulida esa 11,1±3,3 sm dan 5,4±0,8 sm gacha kamaydi (p<0,05). Operatsiyadan keyingi asoratlar va intensiv terapiyada davolanish muddati nazorat guruhiga nisbatan sezilarli qisqardi. Uzoq muddatli kuzatuvlarda bemorlarning 10 yillik omon qolish darajasi 85–88 % ni tashkil etdi. Olingan natijalar chap boʻlmacha atrioplastikasini mitral qopqoq nuqsonlari bilan kechuvchi atriomegaliyani davolashda samarali va xavfsiz jarrohlik usuli sifatida tavsiya etish imkonini beradi.
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1. Раскин В.В, Королев C.B., Дземешкевич A.C. и др. Симметричная обьем-редуцирующая «мерседес»-пластика увеличенного левого предсердия // Кардиология, сердечно-сосудистая хирургия 2008. №6. С. 51-56
2. Стасев А.Н. Комбинированное лечение фибрилляции предсердий при митральном пороке сердца // Сибирский медицинский журнал 2011. Т. 26, № 2, Вып. 1. С. 136-139
3. Дземешкевич С. Л., Стивенсон Л. У. Болезни митрального клапана: функция, диагностика, лечение. - М.: ГЭОТАР Медицина, Москва, 2000. - 156 с.
4. Гордеев М.Л., Наимушин А.Б., Худоногова С.Б., Сухова И.В., Карташев Д.И., Елисеев Л.Е., Курапеев Д.И., Успенский В.Е., Шляхто Е.В. Аутотрансплантация сердца у больных с застойной сердечной недостаточностью // Кардиология - 2009. - №3 С. 96-101
5. Bhasin D., Sharma Y.P., Yadav M., Sharma A. Giant left atrium in rheumatic heart disease. // Acta Cardiol 2024. Vol. 79(2). P. 235-237.
6. Di Eusanio, G., Gregorini, R., Mazzola, A., et al. Giant left atrium and mitral valve replacement: risk factor analysis. // European Journal of Cardio-Thoracic Surgery 1988. Vol. - 2(1). P. 151-159.
7. Dzemeshkevich S.L, Korolev S.V, Gramovich V.V, Frolova Y.V, Lugovoy A.N, Dombrovskaya A.V, Babaev M.A, Zaklyazminskaya E.V. Modified chordal sparing mitral valve replacement as effective technique for both stenotic and insufficient mitral valves. // J Cardiovasc Surg (Torino) 2022. Vol. 63(4). P. 498-506.
8. Di Eusanio, M., Gregorini, R., Mazzola, A., Clementi, G., Procaccini, B., & Cavarra, F. (1998). Left atrial reduction in patients with giant left atrium undergoing mitral valve surgery. European Journal of Cardio-Thoracic Surgery, 13(4), 413–418.
9. Kawazoe, K., Beppu, S., Takahara, Y., Nakajima, N., & Tanaka, K. (1983). Surgical treatment of giant left atrium associated with mitral valve disease. The Annals of Thoracic Surgery, 35(4), 393–398.
10. Romano, M. A., Bolling, S. F., & Pagani, F. D. (2004). Left atrial reduction during mitral valve surgery for giant left atrium. The Annals of Thoracic Surgery, 77(6), 1987–1990.
11. Isomura, T., Hisatomi, K., Hirano, A., Maruyama, H., Kosuga, K., & Ohishi, K. (1993). Left atrial plication and mitral valve surgery for giant left atrium. The Journal of Thoracic and Cardiovascular Surgery, 106(5), 885–887.
12. Badhwar, V., Rankin, J. S., Damiano, R. J., Gillinov, A. M., Bakaeen, F. G., Edgerton, J. R., ... Bolling, S. F. (2017). The Society of Thoracic Surgeons 2017 Clinical Practice Guidelines for the Surgical Treatment of Atrial Fibrillation. The Annals of Thoracic Surgery, 103(1), 329–341.
13. Otto, C. M., Nishimura, R. A., Bonow, R. O., Carabello, B. A., Erwin, J. P., Gentile, F., et al. (2021). 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease. Circulation, 143(5), e72–e227.
14. Vahanian, A., Beyersdorf, F., Praz, F., Milojevic, M., Baldus, S., Bauersachs, J., et al. (2022). 2021 ESC/EACTS Guidelines for the management of valvular heart disease. European Heart Journal, 43(7), 561–632.
15. Gillinov, A. M., Blackstone, E. H., McCarthy, P. M., et al. (2005). Atrial fibrillation: Current surgical treatment. The Journal of Thoracic and Cardiovascular Surgery, 129(5), 1041–1045.
16. Tsang, T. S. M., Barnes, M. E., Gersh, B. J., Bailey, K. R., & Seward, J. B. (2002). Left atrial volume: Important risk marker of cardiovascular outcome. Mayo Clinic Proceedings, 77(10), 1012–1017.
17. Nkomo, V. T., Gardin, J. M., Skelton, T. N., Gottdiener, J. S., Scott, C. G., & Enriquez-Sarano, M. (2006). Burden of valvular heart diseases: A population-based study. The Lancet, 368(9540), 1005–1011.
18. Carpentier, A. (1983). Cardiac valve surgery—The “French correction.” The Journal of Thoracic and Cardiovascular Surgery, 86(3), 323–337.
19. David, T. E., Armstrong, S., McCrindle, B. W., & Manlhiot, C. (2013). Late outcomes of mitral valve repair for mitral regurgitation due to degenerative disease. The Annals of Thoracic Surgery, 95(2), 526–531.
20. Yuda, S., Nakatani, S., Kosakai, Y., Yamagishi, M., & Miyatake, K. (2001). Long-term follow-up of left atrial size and function after mitral valve surgery. The American Journal of Cardiology, 87(6), 763–766.
21. Braunwald, E. (Ed.). (2022). Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine (12th ed.). Elsevier.
22. Zoghbi, W. A., Adams, D., Bonow, R. O., Enriquez-Sarano, M., Foster, E., Grayburn, P. A., et al. (2017). Recommendations for noninvasive evaluation of native valvular regurgitation. Journal of the American Society of Echocardiography, 30(4), 303–371.
