Минимально инвазивный подход в хирургии корня аорты: особенности становления, современные реалии и будущие перспективы

В течение последнего десятилетия минимально инвазивные процедуры в объеме частичной верхней мини-стернотомии и правосторонней мини-торакотомии стали «золотым стандартом» для изолированного протезирования аортального клапана. Однако в хирургии корня аорта минимально инвазивный подход не применяется рутинно, полная срединная стернотомия остается методом выбора для данной когорты больных. Целью данного исследования было проведение аналитического обзора литературы доступной в базах данных, обращая внимание на исторические аспекты, особенности современных методик и будущие перспективы минимально инвазивной хирургии корня аорты. Поиск литературы проводился в международных базах данных Medline, Google scholar и Cochrane library, а также в отечественном источнике «eLibrary.Ru — российская научная электронная библиотека».

Существующие на сегодняшний день исследования показывают многообещающие клинические результаты применения мини-инвазивных доступов в хирургии корня аорты: сопоставимые со срединной стернотомией безопасность и эффективность процедуры, а также ряд преимуществ в виде низкой кровопотери, быстрого восстановительного периода, сниженного риска инфекционных осложнений, прекрасного косметического результата. Однако вышеописанные исследования имеют низкий уровень доказательной базы. Подтверждение полученных результатов рандомизированными клиническими исследованиями с длительным периодом наблюдения позволит сделать минимально инвазивный подход доступом выбора для большинства пациентов, требующих вмешательства на корне аорты.

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