Aortic valve stenosis is one of the most common diseases from the group of acquired heart disease, especially in elderly patients. Aortic valve replacement has become the “gold standard” and gives excellent results in all age groups of patients. For aortic valve replacement is sent to only one third of patients due to high risk due to age, severity of the defect, reduced contractility of the left ventricle, pulmonary hypertension and other comorbidities. One of the attempts to reduce the frequency of complications and mortality in this group of patients, and subsequently to make it possible to perform other surgical interventions, including aortic valve replacement, which is considered inoperable patients is holding a less traumatic surgery - aortic balloon catheter valvuloplasty. In the clinical observation deals with the case of heart disease - critical aortic stenosis, ischemic heart disease complicated by pulmonary hypertension and severe heart failure, in combination with gynecological diseases (uterine fibroids, endometrial hyperplasia in postmenopausal women), complicated by uterine bleeding and hemorrhagic anemia. Consider the risks of different surgical interventions. The possibility of modern endovascular care of patients in this situation simultaneously perform operations on uterine artery embolization, coronary angioplasty with stenting and aortic catheter balloon valvuloplasty. Also shown is the nearest and remote results of operative intervention.
Aortic stenosis is the most common disease from the group of acquired heart diseases. The frequency and degree of damage of the aortic valve increases with age. The prevalence of this disease increases due to the general extension in life expectancy of the population. Aortic valve stenosis caused by calcification is the pathology with progressive course characterized by a poor prognosis at the stage of expanded symptoms. Five-year survival of patients with developed clinical picture of aortic stenosis without surgery, according to some estimates, is reduced to 15%, which is the worst figure, even in comparison with most potentially incurable cancer. In the treatment of aortic stenosis aortic valve replacement is the “gold standard” and gives positive results in all age groups of patients. Only one third of patients are sent for aortic valve replacement owing to high risk caused by the age, severity of the defect, reduced contractility of the left ventricle, pulmonary hypertension and other comorbidities. Aortic valve replacement in patients of the older age groups with concomitant diseases is associated with high level of hospital mortality. One of the attempts to reduce the frequency of complications and mortality in this group of patients is the implementation of a less traumatic surgery – transcatheter aortic valve implantation. At present our clinic has successfully performed more than 70 operations of transcatheter aortic valve implantation. Transcatheter aortic valve implantation is a good alternative to standard aortic valve replacement in patients with high risk of open-heart surgery.
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