mesЭкстремальная биомедицинаExtreme Medicine3033-89643033-8972Centre for Strategic Planning of the Federal Medical and Biological Agency10.47183/mes.2023.012mes-167Research ArticleКЛИНИЧЕСКИЙ СЛУЧАЙCLINICAL CASEТрансмитральная миоэктомия и протезирование митрального клапана из минидоступа при обструктивной гипертрофической кардиомиопатииMini-invasive transmitral myectomy and mitral valve replacement in obstructive hypertrophic cardiomyopathy caseЗемлянниковИ. Д.ZemlyannikovI. D.

Иван Дмитриевич Землянниковул. Островитянова, д. 1, г. Москва, 117997

Ivan D. ZemlyannikovOstrovityanova, 1, Moscow, 117997

emlyannikovivan@gmail.comЦарегородцевА. В.TsaregorodtsevA. V.

Москва

Moscow

НгуенХ. Н.NguyenH. N.

Москва

Moscow

ФерзалиеваЗ. Р.FerzalievaZ. R.

Москва

Moscow

ДрождинаА. А.DrozhdinaA. A.

Москва

Moscow

Российский национальный исследовательский медицинский университет имени Н. И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian FederationНациональный медицинский исследовательский центр сердечно-сосудистой хирургии имени А. Н. БакулеваРоссияBakulev National Medical Research Center of Cardiovascular SurgeryRussian Federation202327102024252112116Copyright © Землянников И.Д., Царегородцев А.В., Нгуен Х.Н., Ферзалиева З.Р., Дрождина А.А., 20242024Землянников И.Д., Царегородцев А.В., Нгуен Х.Н., Ферзалиева З.Р., Дрождина А.А.Zemlyannikov I.D., Tsaregorodtsev A.V., Nguyen H.N., Ferzalieva Z.R., Drozhdina A.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.extrememedicine.ru/jour/article/view/167

Гипертрофическая кардиомиопатия (первичная) — это изолированное генетическое заболевание сердца, выражающееся в утолщении миокарда без явной гемодинамической причины. Существует два механизма обструкции: статический — мышечный валик, стенозирующий выносящий тракт левого желудочка, и динамический — удлиненная передняя створка митрального клапана. Понимание механизма обструкции является ключом к правильному лечению. Золотым стандартом инвазивного лечения обструктивной гипертрофической кардиомиопатии является миоэктомия, устраняющая статический компонент обструкции. Ее дополняют вмешательствами на митральном клапане, которые помогают устранить динамический компонент обструкции. В статье представлен клинический случай успешной трансмитральной миоэктомии и протезирования митрального клапана из мини-торакотомии при обструктивной гипертрофической кардиомиопатии с поражением митрального клапана.

Primary hypertrophic cardiomyopathy is an isolated genetic heart disease characterized by thickening of the myocardium in the absence of an apparent hemodynamic cause. There are two patterns of the obstruction: static, with a muscle band narrowing the outflow tract of the left ventricle, and dynamic, which implies elongation of the anterior mitral valve leaflet. The key to correct treatment of the condition is understanding of the mechanism behind the obstruction. Myectomy is the gold standard of invasive treatment of obstructive hypertrophic cardiomyopathy; it aims to remove the static component of the obstruction. Another common adidition is the mitral valve surgery, aimed at elimination of the obstruction's dynamic component. This article presents a successful mini-invasive transmitral myectomy and mitral valve replacement in a case of obstructive hypertrophic cardiomyopathy with a damaged mitral valve.

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