inovmedИнновационная медицина КубаниInnovative Medicine of Kuban2541-9897Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 1inovmed-56Research ArticleСЛУЧАИ ИЗ ПРАКТИКИCASE REPORTSОСОБЕННОСТИ ОРТОТОПИЧЕСКОЙ ТРАНСПЛАНТАЦИИ СЕРДЦА ПРИ НЕСООТВЕТСТВИИ ДИАМЕТРОВ АОРТ ДОНОРА И РЕЦИПИЕНТАSOME FEATURES OF ORTHOTOPIC HEART TRANSPLANTATION WITH DISCREPANCIES BETWEEN DONOR AND RECIPIENT AORTIC DIAMETERSБарбухаттиК. О.BarbukhattiK. O.noemail@neicon.ruПыхтеевВ. С.PykhteevV. S.noemail@neicon.ruБабешкоС. С.BabeshkoS. S.s.babeshko@mail.ruКаледаВ. И.KaledaV. I.noemail@neicon.ruПорхановВ. А.PorhanovV. A.noemail@neicon.ruНаучно-исследовательский институт – Краевая клиническая больница № 1 им. проф. С.В. Очаповского Министерства здравоохранения Краснодарского краяРоссияScientific Research Institute – Ochapovsky Regional Clinical Hospital no. 1, The Krasnodar Krai Ministry of HealthRussian FederationКубанский государственный медицинский университет Министерства здравоохранения РФРоссияKuban State Medical University, Ministry of Health of the Russian FederationRussian Federation201730032017514248Copyright © Барбухатти К.О., Пыхтеев В.С., Бабешко С.С., Каледа В.И., Порханов В.А., 20172017Барбухатти К.О., Пыхтеев В.С., Бабешко С.С., Каледа В.И., Порханов В.А.Barbukhatti K.O., Pykhteev V.S., Babeshko S.S., Kaleda V.I., Porhanov V.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.innovmedkub.ru/jour/article/view/56

В настоящее время трансплантация сердца является самым эффективным методом лечения больных c терминальной стадией сердечной недостаточности. При этом количество потенциальных реципиентов во всем мире в несколько десятков раз превосходит число проводимых пересадок сердца [1]. Из-за ограниченного количества доноров встает вопрос о необходимости максимально рационального использования донорских органов [2]. Дефицит донорских сердец подтолкнул трансплантологов к расширению критериев отбора донорских органов и их изъятие у так называемых субоптимальных доноров, что привело к увеличению количества и своевременности выполнения трансплантации [3, 4, 5]. В настоящей статье показаны два клинических случая успешной ортотопической трансплантации сердца (ОТС) с использованием донорских сердец, значимо отличающихся от реципиента по диаметру аорт, что явилось причиной выполнения редукционной аортопластики аорты реципиента. Кроме того, представлен случай ОТС реципиенту с аневризмой восходящего отдела аорты, осложненной диссекцией II типа по Дебейки, которому после удаления больного сердца, перед непосредственным проведением трансплантации, первым этапом выполнялось супракоронарное протезирование восходящего отдела и частично дуги аорты.

At present heart transplantation is the most effective method for treating patients with terminal stage of heart insufficiency. And now the number of possible recipients exceeds the number of performing transplantations several times in the world [1]. Due to the limited number of donors there is a necessity to rational employment for donor organs [2]. Deficit of donor hearts urged on surgeons to extend selection criteria and demands for heart harvesting in so called suboptimal donors which leads to increased number and timeliness performance of transplantations [3, 4, 5]. In the present article we demonstrated two clinical cases with successful orthotopic heart transplantation (OHT) with donor organs usage, which differed rather significantly regarding aortic dimensions, and this fact necessitated performance of reduction aortoplasty in recipients. Besides, we presented a case with aт OHT patient with ascending aorta aneurism, complicated dissection type II DeBakey, who was indicated supracoronary grafting of the ascending aorta and a part of aortic arch before the transplantation.

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