emcardioНеотложная кардиология и кардиоваскулярные рискиEmergency Cardiology and Cardiovascular Risks journal2616-633XБелорусский государственный медицинский университетemcardio-259Research ArticleКлинический случайУспешное хирургическое лечение дефекта межжелудочковой перегородки и аневризмы левого желудочка в остром периоде инфаркта миокардаSuccessful surgical repair of ventricular septal defect and left ventricle aneurysm in acute myocardial infarctionЯнушкоА. В.YanushkoA. V.СоловьевС. Л.SalauyouS. L.ЛюткевичЮ. Т.LiutkevichYu. T.КизюкевичИ. Л.KiziukevichI. L.Учреждение здравоохранения «Гродненский областной клинический кардиологический центрGrodno Regional Clinical Cardiology Center20181311202522418422Copyright © Янушко А.В., Соловьев С.Л., Люткевич Ю.Т., Кизюкевич И.Л., 20252025Янушко А.В., Соловьев С.Л., Люткевич Ю.Т., Кизюкевич И.Л.Yanushko A.V., Salauyou S.L., Liutkevich Y.T., Kiziukevich I.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://emcardio.bsmu.by/jour/article/view/259

Постинфарктный дефект межжелудочковой перегородки (ДМЖП) - редкое, но смертельное осложнение, развивающееся в течение первых двух недель от начала инфаркта миокарда. Пациенты с ДМЖП умирают от явлений быстро нарастающей сердечной недостаточности в течение нескольких дней. Тем не менее, сроки оперативного лечения пациентов с такой жизнеугрожающей патологией продолжают оставаться предметом обсуждения. Более «агрессивный» подход предполагает выполнение вмешательства в кратчайшие сроки после диагностики ДМЖП; в то время как выжидательная тактика направлена на стабилизацию гемодинамики с помощью устройств вспомогательного кровообращения с последующим выполнения отсроченного радикального оперативного лечения. Мы представляем клинический случай пациента с острым инфарктом миокарда (ОИМ), который перенес успешное хирургическое лечение двух жизнеугрожающих осложнений ОИМ: ДМЖП и аневризмы задней стенки левого желудочка.

Postinfarction ventricular septal defect (VSD) is a rare, but fatal complication developing within the first two weeks from the onset of myocardial infarction (MI). Patients with VSD most frequently die of acute decompensated heart failure within several days. Nevertheless, the timing of surgical repair still remains under consideration. A more «aggressive» approach implies closing the defect in the shortest possible time period after VSD is diagnosed; whereas some surgeons advocate stabilization of patients’ hemodynamics by means of circulatory support devices with the subsequent delayed surgical treatment. We present a clinical case of the patient with acute myocardial infarction who underwent successful surgical treatment for two life-threatening complications of acute MI: VSD and posterior aneurysm of the left ventricle

постинфарктный дефект межжелудочковой перегородкианевризма задней стенки левого желудочкаосложнения острого инфаркта миокардаэкстракорпоральная мембранная оксигенация (ЭКМО)postinfarction ventricular septal defectposterior aneurysm of the left ventriclecomplications of acute myocardial infarctionExtracorporeal membrane oxygenation (ЕСМО)ReferencesBirnbaum Y., Fishbein M., Blanche C., Siegel R.J. Ventricular septal rupture after acute myocardial infarction. N Engl J Med, 2002, vol. 347, № 18, pp. 1426-1432.Birnbaum Y., Fishbein M., Blanche C., Siegel R.J. Ventricular septal rupture after acute myocardial infarction. N Engl J Med, 2002, vol. 347, № 18, pp. 1426-1432.Poulsen S.H., Praestholm M., Munk K., Wierup P., Egeblad H., Nielsen- Kudsk J.E. Ventricular septal rupture complicating acute myocardialinfarction: clinical characteristics and contemporary outcome. 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The authors declare that there are no conflicts of interest present.