СПИРТОВАЯ СЕПТАЛЬНАЯ АБЛЯЦИЯ МЕЖЖЕЛУДОЧКОВОЙ ПЕРЕГОРОДКИ С КОНТРАСТНЫМ ЭХОКАРДИОГРАФИЧЕСКИМ КОНТРОЛЕМ

Спиртовая септальная абляция была впервые предложена в 1994 г. в качестве альтернативы хирургической септальной миэктомии у пациентов с обструктивной гипертрофической кардиомиопатией, рефрактерной к медикаментозной терапии. Данная процедура уменьшает симптомы заболевания, образуя целенаправленный, ограниченный инфарктный очаг верхней части межжелудочковой перегородки, что приводит к увеличению диаметра выходного отдела левого желудочка, снижению градиента давления на уровне выходного отдела левого желудочка и регрессу гипертрофии левого желудочка, который был вызван перегрузкой давлением. Подобного улучшения клинических проявлений удается достичь в большинстве случаев. Основное осложнение спиртовой септальной абляции – развитие полной атриовентрикулярной блокады, в связи с чем у некоторых пациентов возникает необходимость установки постоянного кардиостимулятора. Применение эхокардиографии с контрастированием миокарда во время спиртовой септальной абляции позволяет ограничить размер инфаркта миокарда, использовать меньшее количества спирта и, соответственно, уменьшить частоту осложнений.

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