Окклюзия ушка левого предсердия – немедикаментозный метод профилактики кардиоэмболических осложнений у пациентов с фибрилляцией предсердий. Авторы указывают, что ввиду высокой распространенности ФП в мире и России постоянно увеличивается количество пациентов, нуждающихся в антикоагулянтной терапии, но имеющих ограничения в ее применении.
Цель. Изучить роль окклюдеров ушка левого предсердия (ОУЛП) в профилактике системной эмболии у больных с фибрилляцией предсердий (ФП).
Материалы и методы. Обзор основан на анализе данных из баз PubMed и Google Scholar за последние 5 лет.
Выводы. Базовая терапия при фибрилляции предсердий включает антикоагулянты, но их применение ограничено противопоказаниями, что делает актуальной немедикаментозную профилактику. Существуют методы иссечения (удаление ушка с ушиванием) и окклюзии (исключение из кровотока без удаления), причем последние предпочтительнее: они безопаснее, реже осложняются и проще выполняются. Наиболее распространен метод установки окклюзионных устройств, таких как окклюдеры Watchman и Amplatzer, зарекомендовавшие себя обширной доказательной базой. Дальнейшие исследования необходимы для подтверждения клинической значимости окклюзии ушка левого предсердия через крупные рандомизированные испытания с четкими хирургическими и антикоагулянтными протоколами.
Клинические рекомендации: Фибрилляция и трепетание предсердий у взрослых. Министерство здравоохранения Российской Федерации. 2022.
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