МИНИ-ИНВАЗИВНОЕ ПРОТЕЗИРОВАНИЕ АОРТАЛЬНОГО КЛАПАНА У 97-ЛЕТНЕГО ПАЦИЕНТА

Abstract

This review focuses on the choice of treatment strategy in elderly patients with severe aortic stenosis. The variability of surgical approaches and options, often limited due to excessive caution associated with the age-relative peculiarities of such patients has been shown in this study. The effectiveness of a multidisciplinary and integrated approach has been demonstrated, the result of which is measured by improving the quality and duration of the patient’s life. A case of mini-invasive aortic valve replacement in a 97-year-old patient is unique for the world literature. The key indicators that undoubtedly influence the choice of treatment tactics for an elderly patient are: the patient’s general condition, comorbidity and the ability of quick postoperative rehabilitation. Thus, minimally invasive surgery and transcatheter aortic valve implantation (TAVI) are considered to be the methods of choice for these patients. TAVI as an option is not always available, particular in countries with unstable economic conditions. In the given case, a multi-stage preoperative preparation of patient was performed to stabilize the general condition and to compensate the comorbidity. Thus, the preoperative period optimization for high-risk patients facilitated the rapid rehabilitation and adaptation after the operation. Anysurgical procedurehasrisks associatedwith it, so the hybrid approach, widely used in a current clinical cardiac surgery, is especially valuable in the context of treating elderly patients, since it minimizestheserisks.