russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2019-8-124-131russjcardiol-3364Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWПериоперационный инфаркт миокарда при выполнении коронарного шунтирования. Основные подходы к диагностике и профилактикеPerioperative myocardial infarction during coronary artery bypass grafting. The main approaches to diagnosis and preventionhttps://orcid.org/0000-0002-8079-5397АргуноваЮ. А.ArgunovaYu. A.argunova-u@mail.ruhttps://orcid.org/0000-0002-6209-4669ЛарионовМ. В.LarionovM. V.

Максим Валерьевич Ларионов — кандидат медицинских наук, научный сотрудник лаборатории критических состояний

SPIN-код: 1858-1237. 

Кемерово

larionov1606@gmail.comФГБНУ Научно-исследовательский институт комплексных проблем сердечнососудистых заболеванийРоссияResearch Institute for Complex Issues of Cardiovascular DiseasesRussian FederationФГБНУ Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеванийРоссияResearch Institute for Complex Issues of Cardiovascular DiseasesRussian Federation20191406201908124131Copyright © Аргунова Ю.А., Ларионов М.В., 20192019Аргунова Ю.А., Ларионов М.В.Argunova Y.A., Larionov M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/3364

В условиях роста числа выполняемых операций коронарного шунтирования (КШ) в мире сохраняется высокой частота развития периоперационных осложнений, в том числе периоперационного повреждения и инфаркта миокарда (ИМ). Данные состояния являются предикторами неблагоприятного прогноза в послеоперационном периоде. Это актуализирует разработку четких критериев диагностики этих состояний и поиск мер профилактики.

Методы кардиопротекции используются на всех этапах ведения пациента в периоперационном периоде КШ. Наиболее эффективным является использование комплексного подхода к подготовке пациента (преабилитации), обеспечению интраоперационной кардиопротекции, коррекции факторов риска в послеоперационном периоде.

В обзоре представлены современные подходы к диагностике ИМ, ассоциированного с КШ, а также основные представления о профилактике этого состояния на всех этапах ведения пациента.  

The incidence of perioperative complications, including perioperative myocardial damage and infarction, remains high with the increasing number of coronary artery bypass grafting (CABG) performed worldwide. These conditions are predictors of poor prognosis in the postoperative period. Therefore, it is relevant to develop strict diagnostic criteria for these conditions and to search for optimal preventive measures.

Cardioprotection is used at all stages of patient management in the perioperative period after CABG. The comprehensive approach containing preoperative management of the patient (prehabilitation), intraoperative cardioprotection and risk factor management in the postoperative period is considered to be the most effective one.

The review presents current approaches to the diagnosis of myocardial infarction after CABG, as well as the basic concepts of its prevention at all stages of patient management.

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