cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2025-2379cardiotomsk-2379Research ArticleОБЗОРЫREVIEWSВыбор кондуита для реконструкции пути оттока от правого желудочка (обзор литературы)Selection of a conduit for right ventricular outflow tract reconstruction (a literature review)https://orcid.org/0000-0002-1562-046XПетшаковскийП. Ю.PetshakovskiyP. J.

Петшаковский Павел Юрьевич - кардиохирург, кардиохирургическое отделение № 1, НИИ ККБ № 1 им. С.В. Очаповского.

350086, Краснодар, ул. 1 Мая, 167

Pavel J. Petshakovskiy - Cardiac Surgeon, Cardiac Surgery Department No. 1, Research Institute - S.V. Ochapovsky Regional Clinical Hospital No. 1.

167, 1 May str., Krasnodar, 350086

pavpetsh2@gmail.comhttps://orcid.org/0000-0002-7064-9935БорисковМ. В.BoriskovM. V.

Борисков Максим Валентинович - канд. мед. наук, заведующий кардиохирургического отделения № 1, НИИ ККБ№1 им. С.В. Очаповского.

350086, Краснодар, ул. 1 Мая, 167

Maksim V. Boriskov - Cand. Sc.(Med.), Cardiac Surgeon, Cardiac Surgery Department No. 1, Research Institute - S.V. Ochapovsky Regional Clinical Hospital No. 1.

167, 1 May str., Krasnodar, 350086

mvboriskov@yandex.ruhttps://orcid.org/0000-0001-7777-7457ЕфимочкинГ. А.EfimochkinG. A.

Ефимочкин Георгий Алексеевич - канд. мед. наук, кардиохирург кардиохирургического отделения № 1, НИИ ККБ № 1 им. С.В. Очаповского.

350086, Краснодар, ул. 1 Мая, 167

Georgii A. Efimochkin - Cand. Sci. (Med.), Cardiac Surgeon, Cardiac Surgery Department No. 1, Research Institute - S.V. Ochapovsky Regional Clinical Hospital No. 1.

167, 1 May str., Krasnodar, 350086

georgith@rambler.ruhttps://orcid.org/0000-0002-9932-9273ВанинО. А.VaninO. A.

Ванин Олег Александрович - кардиохирург кардиохирургического отделения № 1, НИИ ККБ № 1 им. С.В. Очаповского.

350086, Краснодар, ул. 1 Мая, 167

Oleg A. Vanin - Cardiac Surgeon, Cardiac Surgery Department No. 1, Research Institute - S.V. Ochapovsky Regional Clinical Hospital No. 1.

167, 1 May str., Krasnodar, 350086

olegvanin696@mail.ruhttps://orcid.org/0000-0001-6727-0978ИофеЕ. И.IofeE. I.

Иофе Елена Игоревна - кардиохирург кардиохирургического отделения № 1, НИИ ККБ № 1 им. С.В. Очаповского.

350086, Краснодар, ул. 1 Мая, 167

Elena I. Iofe - Cardiac Surgeon, Cardiac Surgery Department No. 1, Research Institute - S.V. Ochapovsky Regional Clinical Hospital No. 1.

167, 1 May str., Krasnodar, 350086

helen.iofe@yandex.ruhttps://orcid.org/0000-0002-2626-9273ПереверзеваА. А.PereverzevaA. A.

Переверзева Ангелина Андреевна - кардиохирург, кардиохирургическое отделения № 1, НИИ ККБ № 1 им. С.В. Очаповского.

350086, Краснодар, ул. 1 Мая, 167

Angelina A. Pereverzeva - Cardiac Surgeon, Cardiac Surgery Department No. 1, Research Institute - S.V. Ochapovsky Regional Clinical Hospital No. 1.

167, 1 May str., Krasnodar, 350086

polyahova.angelina@mail.ruhttps://orcid.org/0000-0002-1734-2483ТкаченкоИ. А.TkachenkoI. A.

Ткаченко Илья Александрович - кардиохирург кардиохирургического отделения № 1, НИИ ККБ № 1 им. С.В. Очаповского.

350086, Краснодар, ул. 1 Мая, 167

Ilya A. Tkachenko - Cardiac Surgeon, Cardiac Surgery Department No. 1, Research Institute - S.V. Ochapovsky Regional Clinical Hospital No. 1.

167, 1 May str., Krasnodar, 350086

tkachenko1791@gmail.comГБУЗ «Научно-исследовательский институт – Краевая клиническая больница № 1 имени профессора С.В. Очаповского» Минздрава Краснодарского краяРоссияScientific Research Institute - Ochapovsky Regional Clinical Hospital No 1, Krasnodar Region, Ministry of Public HealthRussian Federation2026090720264125663Copyright © Петшаковский П.Ю., Борисков М.В., Ефимочкин Г.А., Ванин О.А., Иофе Е.И., Переверзева А.А., Ткаченко И.А., 20262026Петшаковский П.Ю., Борисков М.В., Ефимочкин Г.А., Ванин О.А., Иофе Е.И., Переверзева А.А., Ткаченко И.А.Petshakovskiy P.J., Boriskov M.V., Efimochkin G.A., Vanin O.A., Iofe E.I., Pereverzeva A.A., Tkachenko I.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.sibjcem.ru/jour/article/view/2379Актуальность

Актуальность. В течение шести десятилетий при реконструкции пути оттока от правого желудочка выбор кондуита был и остается сложной задачей для кардиохирургов. Среди обширного количества предлагаемых клапанных протезов выбор его материала до сих пор остается спорным. Существуют различные аллотрансплантаты, ксенотрансплантаты, сочетание дакроновых линейных протезов с имплантированным внутрь запирательным элементом из биологической ткани и механических материалов. Популяризируются синтетические протезы с клапанами ручной работы из расширенного политетрафторэтилена (ePTFE) и биорезорбируемые тканеинженерные кондуиты. Постоянный поиск лучшего кондуита вызван неудовлетворительными отдаленными результатами функционирования протезов. Основная проблема связана с неизбежной биодеградацией материала, из которого изготовлен протез. Долговечность – основной и самый важный показатель качества кондуитов.

Цель

Цель: на основании анализа данных литературы провести обзор кондуитов, применяемых для реконструкции пути оттока от правого желудочка.

Методология поиска

Методология поиска. Поиск исследований осуществлялся на основе баз данных Medline (PubMed) и РИНЦ с использованием поисковых запросов, ключевых слов и логических операторов.

По данным анализа литературы были изучены аспекты выбора кондуита для имплантации в легочную позицию, представлены основные осложнения, непосредственные и отдаленные послеоперационные результаты.

Заключение

Заключение. Выбор кондуита для реконструкции пути оттока от правого желудочка остается ключевым фактором, определяющим эффективность хирургического лечения и отдаленные результаты у пациентов различных возрастных групп. Перспективными направлениями являются разработка и внедрение новых биологических и синтетических кондуитов, способных обеспечить лучшие отдаленные результаты и повысить долговечность реконструкции.

Relevance

Relevance. For six decades, in reconstructing the right ventricular outflow tract, the choice of conduit has been – and remains – a challenge for cardiac surgeons. Among the vast number of available valve prostheses, the choice of material is still debated. Various allografts, xenografts, combinations of Dacron tube grafts with an incorporated occlusive element made of biological tissue, and mechanical materials exist. Synthetic prostheses with handcrafted valves made of expanded polytetrafluoroethylene (ePTFE) and bioresorbable tissue-engineered conduits are gaining popularity. The ongoing search for the optimal conduit is driven by unsatisfactory long-term outcomes of prosthetic function. The main issue is the in-evitable biodegradation of the material from which the prosthesis is made. Durability is the most important indicator of conduit quality.

Aim

Aim: To review conduits used for right ventricular outflow tract reconstruction based on an analysis of published literature.

Methods

Methods. A search for studies was conducted using the Medline (PubMed) and the Russian Science Citation Index (RSCI) databases with search queries, keywords, and logical operators.

Results

Results. Based on a systematic literature review, aspects of conduit selection for implantation in the pulmonary position were examined, and the main complications as well as early and long-term postoperative outcomes are presented.

Conclusion

Conclusion. The choice of conduit for right ventricular outflow tract reconstruction remains a key factor determining the effectiveness of surgical treatment and long-term outcomes in patients of different age groups. Promising directions include the development and implementation of new biological and synthetic conduits capable of providing better long-term results and increasing the durability of the reconstruction.

реконструкция пути оттока от правого желудочкаклапаносодержащий кондуитгомографталлографтксенографтклапанный кондуит из ePTFEreconstruction of the outflow pathway from the right ventriclevalvеcontaining conduithomographallografxenograftvalved conduit ePTFEИсследование выполнено при финансовой поддержке Кубанского научного фонда в рамках научно-инновационного проекта № НИП-20.1/22.22.The research was carried out with the financial support of the Kuban Scientific Foundation within the framework of the scientific and innovative project No. НИП-20.1/22.22.ReferencesLatus H., Gummel K., Rupp S. et al. Beneficial effects of residual right ventricular outflow tract obstruction on right ventricular volume and function in patients after repair of tetralogy of Fallot. Pediatr. Cardiol. 2013;34:424–430. https://doi.org/10.1007/s00246-012-0476-4Latus H., Gummel K., Rupp S. et al. 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The authors declare that there are no conflicts of interest present.