grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia10.24884/0042-4625-2022-181-6-83-92grekov-2183Research ArticleОБЗОРЫREVIEWSМеханические осложнения инфаркта миокарда: основы патогенеза и подходы к хирургическому лечениюMechanical complications of myocardial infarction: basic aspects of pathogenesis and approaches to surgical treatmenthttps://orcid.org/0000-0001-6128-7138ШенгелияЛ. Д.ShengeliaL. D.

Шенгелия Лаша Давидович, кандидат медицинских наук, сердечно-сосудистый хирург, научный сотрудник

Москва

Shengelia Lasha D., Cand. of Sci. (Med.), Cardiovascular Surgeon, Research Fellow

Moscow

l.d.shengelia@mail.ruhttps://orcid.org/0000-0001-9279-0596ФатулаевЗ. Ф.FatulaevZ. F.

Фатулаев Замик Фахрудинович, кандидат медицинскихнаук, сердечно-сосудистый хирург, ведущий научный сотрудник отделения хирургического лечения интерактивной патологии

Москва

Fatulaev Zamik F., Cand. of Sci. (Med.), Cardiovascular Surgeon, Leading Research Fellow of the Department of Surgical Treatment of Interactive Pathology

Moscow

zffatulaev@bakulev.ruhttps://orcid.org/0000-0003-0942-2931ДонаканянС. А.DonakanyanS. A.

Донаканян Сергей Агванович, доктор медицинских наук, профессор, руководитель отделения хирургического отделения интерактивной патологии

Москва

Donakanyan Sergey A., Dr. of Sci. (Med.), Professor, Head of the Department of the Surgical Department of Interactive Pathology

Moscow

sadonakanyan@bakulev.ruhttps://orcid.org/0000-0002-4436-0222КоншинаМ. О.KonshinaM. O.

Коншина Мария Олеговна, клинический ординатор по специальности «Кардиология»

Москва

Konshina Maria O., Clinical Resident in the specialty «Cardiology»

Moscow

drmariakonshina@gmail.comhttps://orcid.org/0000-0003-2018-9077ПанаговЗ. Г.PanagovZ. G.

Панагов Залим Григорьевич, аспирант

Москва

Panagov Zalim G., Postgraduate Student

Moscow

zalim.panagov@yandex.ruhttps://orcid.org/0000-0002-6180-2619БокерияЛ. А.BockeriaL. A.

Бокерия Лео Антонович, доктор медицинских наук, академик РАН, Президент

Москва

Bockeria Leo A., Dr. of Sci. (Med.), Professor, Academician of the Russian Academy of Sciences

Moscow

leoan@heart-house.ruФедеральное государственное бюджетное учреждение «Научный медицинский исследовательский центр сердечно-сосудистой хирургии им. А. Н. Бакулева»РоссияA. N. Bakulev National Medical Research Center of Cardiovascular SurgeryRussian Federation20221702202318168392Copyright © Шенгелия Л.Д., Фатулаев З.Ф., Донаканян С.А., Коншина М.О., Панагов З.Г., Бокерия Л.А., 20232023Шенгелия Л.Д., Фатулаев З.Ф., Донаканян С.А., Коншина М.О., Панагов З.Г., Бокерия Л.А.Shengelia L.D., Fatulaev Z.F., Donakanyan S.A., Konshina M.O., Panagov Z.G., Bockeria L.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/2183

Ишемическая болезнь сердца занимает лидирующую позицию среди смертности взрослого населения. Наибольшая летальность среди всех форм ишемической болезни сердца отмечается при развитии инфаркта миокарда. При этом, непосредственной причиной смерти являются осложнения инфаркта миокарда.  С момента появления катетерной и хирургической реперфузии произошло значительное снижение частоты этих осложнений. Однако, пациенты с обширными инфарктами или те, кто не получают своевременной необходимой реваскуляризации, остаются в группе риска механических осложнений острого инфаркта миокарда. Наиболее часто встречающимися механическими осложнениями являются разрыв папиллярных мышц митрального клапана и острая митральная недостаточность, дефект межжелудочковой перегородки, формирование аневризм и псевдоаневризм, разрыв свободной стенки желудочка. Данные осложнения встречаются не так часто, однако прогноз неблагоприятный и сопряжен с высокой летальностью на догоспитальном и госпитальном этапе. Ранняя диагностика, определение оптимальной тактики лечения имеют решающее значение для увеличения выживаемости больных.  

Ischemic heart disease is a leading cause of mortality of the adult population. The most mortality of all forms of ischemic heart disease is occurred with development of myocardial infarction. Meanwhile, the direct cause of death are complications of myocardial infarction. Since the advent of catheter-based and surgical reperfusion, there has been a significant decrease in the frequency of these complications. However, patients with large myocardial infarctions or those who do not receive necessary revascularization in time remain at risk of mechanical complications of acute myocardial infarction. The most common mechanical complications are rupture of the papillary muscles of the mitral valve and acute mitral regurgitation, interventricular septal defect, forming of aneurysms and pseudoaneurysms, and free-wall rupture. Although these complications are rare, their prognosis is unfavourable and is associated with high mortality at the prehospital and hospital stage. Early diagnosis, determination of optimal treatment tactics are crucial for increasing the survival rate of patients.

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