Замена аортального клапана

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xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-chevron-right" viewbox="0 0 284.49 498.98" fill="currentColor" width="20" height="20" > <path d="M35 498.98a35 35 0 0 1-24.75-59.75l189.74-189.74L10.25 59.75a35.002 35.002 0 0 1 49.5-49.5l214.49 214.49a35 35 0 0 1 0 49.5L59.75 488.73A34.89 34.89 0 0 1 35 498.98" /> </svg> <span class="icon__fallback-text visually-hidden"> Expand submenu </span> </span> </button> <ul class="slide-nav__dropdown" data-parent="tier-3-special-topics1" data-level="3" > <li class="slide-nav__item"> <button type="button" class="slide-nav__button js-toggle-submenu" data-target="tier-2-expert-masterclasses1" > <span class="slide-nav__link slide-nav__link--back"> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-chevron-right" viewbox="0 0 284.49 498.98" fill="currentColor" width="20" height="20" > <path d="M35 498.98a35 35 0 0 1-24.75-59.75l189.74-189.74L10.25 59.75a35.002 35.002 0 0 1 49.5-49.5l214.49 214.49a35 35 0 0 1 0 49.5L59.75 488.73A34.89 34.89 0 0 1 35 498.98" /> </svg> <span>Special Topics</span> </span> </button> </li> <li class="slide-nav__item"> <a href="/collections/public-health" class="slide-nav__link"> <span> View all </span> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-chevron-right" viewbox="0 0 284.49 498.98" fill="currentColor" width="20" height="20" > <path d="M35 498.98a35 35 0 0 1-24.75-59.75l189.74-189.74L10.25 59.75a35.002 35.002 0 0 1 49.5-49.5l214.49 214.49a35 35 0 0 1 0 49.5L59.75 488.73A34.89 34.89 0 0 1 35 498.98" /> </svg> </a> </li><li class="slide-nav__item"> <a href="/collections/womens-health" class="slide-nav__link"> <span>Women's Health. 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d="M35 498.98a35 35 0 0 1-24.75-59.75l189.74-189.74L10.25 59.75a35.002 35.002 0 0 1 49.5-49.5l214.49 214.49a35 35 0 0 1 0 49.5L59.75 488.73A34.89 34.89 0 0 1 35 498.98" /> </svg> <span class="icon__fallback-text visually-hidden"> Expand submenu </span> </span> </button> <ul class="slide-nav__dropdown" data-parent="tier-2-about-us4" data-level="2" > <li class="slide-nav__item"> <button type="button" class="slide-nav__button js-toggle-submenu" > <span class="slide-nav__link slide-nav__link--back"> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-chevron-right" viewbox="0 0 284.49 498.98" fill="currentColor" width="20" height="20" > <path d="M35 498.98a35 35 0 0 1-24.75-59.75l189.74-189.74L10.25 59.75a35.002 35.002 0 0 1 49.5-49.5l214.49 214.49a35 35 0 0 1 0 49.5L59.75 488.73A34.89 34.89 0 0 1 35 498.98" /> </svg> <span>About us</span> </span> </button> </li> <li class="slide-nav__item"><a href="/pages/our-mission-story" class="slide-nav__link"> <span>Our Mission. Our Story.</span> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-chevron-right" viewbox="0 0 284.49 498.98" fill="currentColor" width="20" height="20" > <path d="M35 498.98a35 35 0 0 1-24.75-59.75l189.74-189.74L10.25 59.75a35.002 35.002 0 0 1 49.5-49.5l214.49 214.49a35 35 0 0 1 0 49.5L59.75 488.73A34.89 34.89 0 0 1 35 498.98" /> </svg> </a></li><li class="slide-nav__item"><a href="/pages/expert-advisory-board" class="slide-nav__link"> <span>Expert Advisory Board</span> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-chevron-right" viewbox="0 0 284.49 498.98" fill="currentColor" width="20" height="20" > <path d="M35 498.98a35 35 0 0 1-24.75-59.75l189.74-189.74L10.25 59.75a35.002 35.002 0 0 1 49.5-49.5l214.49 214.49a35 35 0 0 1 0 49.5L59.75 488.73A34.89 34.89 0 0 1 35 498.98" /> </svg> </a></li><li class="slide-nav__item"><a href="/pages/expert-testimonials" class="slide-nav__link"> <span>Expert Testimonials</span> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-chevron-right" viewbox="0 0 284.49 498.98" fill="currentColor" width="20" height="20" > <path d="M35 498.98a35 35 0 0 1-24.75-59.75l189.74-189.74L10.25 59.75a35.002 35.002 0 0 1 49.5-49.5l214.49 214.49a35 35 0 0 1 0 49.5L59.75 488.73A34.89 34.89 0 0 1 35 498.98" /> </svg> </a></li></ul></li><li class="slide-nav__item"><a href="/pages/contact" class="slide-nav__link"><span>Contact</span> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-chevron-right" viewbox="0 0 284.49 498.98" fill="currentColor" width="20" height="20" > <path d="M35 498.98a35 35 0 0 1-24.75-59.75l189.74-189.74L10.25 59.75a35.002 35.002 0 0 1 49.5-49.5l214.49 214.49a35 35 0 0 1 0 49.5L59.75 488.73A34.89 34.89 0 0 1 35 498.98" /> </svg> </a></li></ul> </mobile-nav> <script type="module"> import 'components/header-mobile-nav' </script> <clone-footer> <div id="MobileNavFooter"></div> </clone-footer> <script type="module"> import '@archetype-themes/modules/clone-footer' </script></div> </header-drawer> <script type="module"> import 'components/header-drawer' </script> </div> </div> </header></header-nav> <script type="module"> import 'components/header-nav' </script> </header-section> <template data-island> <script type="module"> import 'components/section-header' </script> </template> </is-land> </div>  <main class="main-content" id="MainContent"> <div id="shopify-section-template--18622507942044__main" class="shopify-section"> <section class="page-content page-content--product page-content--full" data-section-id="template--18622507942044__main" data-product-id="7374914289820" > <div class="page-width"> <div class="product-grid__container product--images float-grid clearfix"><div class="grid__item medium-up--one-half 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medium-up--one-half"> <div class="product-single__meta"> <nav class="breadcrumb" role="navigation" aria-label="breadcrumbs"> <a href="/" title=" Back to the frontpage " > Home </a> <span class="breadcrumb__divider" aria-hidden="true">/</span> <a href="/collections"> Expert Masterclasses </a> <span class="breadcrumb__divider" aria-hidden="true">/</span> <a href="/collections/heart-valve-aortic-mitral-tricuspid" title="">Клапан сердца [аортальный, митральный, трехстворчатый]</a> <span class="breadcrumb__divider" aria-hidden="true">/</span> </nav> <div class="product-block" data-section-id="template--18622507942044__main" > <h1 class="h2 product-single__title"><!DOCTYPE html> <html lang="ru"> <head> <meta charset="UTF-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <title>Замена аортального клапана</h1></div> <div class="product-block" > <a class="custom-white-button" href="/pages/how-it-works" target="_self" rel="noopener noreferrer"> Can we help? </a> <style> .custom-white-button { background-color: transparent !important; color: #ffffff !important; border: 2px solid #ffffff !important; font-size: 18px !important; padding: 10px 20px !important; text-align: center !important; display: inline-block !important; text-decoration: none !important; } .custom-white-button:hover { background-color: #ff0000 !important; color: #ffffff !important; } </style> </div> </div> </div> <div class="grid__item one-whole"> <div class="product-summary--wide"> <div class="dd-article-summary rte"> <p>Ведущий эксперт по замене аортального клапана, доктор медицинских наук Антон Титов делится мнением о хирургических подходах для пожилых пациентов, подчеркивая важность учёта как биологического возраста, так и готовности пациента. Он обсуждает роль индекса хрупкости в оценке хирургических рисков и отмечает преимущества транскатетерной имплантации аортального клапана (ТКИАК) для пациентов, которым не подходит традиционная операция. Доктор Титов акцентирует значимость самостоятельности пациента и возможность улучшения качества жизни после вмешательства.</p> </div> </div> </div></div> </div> </section> <script type="application/ld+json"> {"@context":"http:\/\/schema.org\/","@id":"\/products\/aortic-valve-replacement-in-elderly-patients#product","@type":"Product","brand":{"@type":"Brand","name":"Diagnostic Detectives Network"},"category":"","description":"Варианты замены аортального клапана у пациентов пожилого возраста\nПерейти к разделу\n\nБиологический возраст vs. хронологический возраст\nВажность информированного согласия пациента\nФакторы риска при хирургических вмешательствах у пожилых\nТранскатетерная имплантация аортального клапана\nИндекс хрупкости и качество жизни\nПолная расшифровка\n\nБиологический возраст vs. хронологический возраст\nДоктор Юрген Энкер, MD, подчёркивает важность разграничения биологического и хронологического возраста при рассмотрении замены аортального клапана у пожилых пациентов. Биологический возраст отражает физическое состояние и функциональную подготовленность пациента, что существенно влияет на возможность проведения операции. Некоторые пациенты старше 80 лет могут быть биологически моложе и лучше подготовлены к кардиохирургическим вмешательствам, что делает их более подходящими кандидатами для операции.\nВажность информированного согласия пациента\nДоктор Юрген Энкер, MD, акцентирует важность добровольного согласия и готовности пациента при принятии решения о замене аортального клапана. Пациенты должны выражать желание на проведение операции и быть готовыми следовать послеоперационным рекомендациям, таким как дыхательная гимнастика и мобилизация. Психологическая готовность и мотивация пациента имеют решающее значение для успешного исхода операции.\nФакторы риска при хирургических вмешательствах у пожилых\nДоктор Юрген Энкер, MD, выделяет несколько факторов риска, которые необходимо учитывать перед проведением операции у пожилых пациентов. К ним относятся предшествующие операции, низкий сердечный выброс и заболевания почек. Для пациентов, приближающихся к 90-летнему возрасту с выраженными факторами риска, традиционная хирургия может не быть оптимальным вариантом. Оценка этих рисков необходима для обеспечения безопасности пациента и оптимизации результатов лечения.\nТранскатетерная имплантация аортального клапана\nДля пациентов, непригодных для традиционной хирургии, доктор Юрген Энкер обсуждает преимущества транскатетерной имплантации аортального клапана (TAVI). Это малоинвазивное вмешательство предполагает установку катетера через паховую область для замены аортального клапана, что исключает необходимость открытой операции на сердце. TAVI представляет собой жизнеспособную альтернативу для пациентов высокого риска, причём примерно 50% пожилых пациентов в Германии проходят эту процедуру.\nИндекс хрупкости и качество жизни\nИндекс хрупкости является ключевым инструментом оценки способности пациента перенести операцию и общего уровня функциональной подготовки. Доктор Юрген Энкер поясняет, что этот индекс помогает определить вероятность успешного исхода и улучшения качества жизни после операции. Для пожилых пациентов замена аортального клапана может значительно продлить ожидаемую продолжительность жизни и улучшить её качество, что делает эту процедуру ценной для тех, кто функционально подготовлен и мотивирован.\nПолная расшифровка\nДоктор Антон Титов, MD: Давайте обсудим замену аортального клапана у пациентов пожилого возраста. У вас очень обширный опыт, включающий публикацию серии из 493 последовательных пожилых пациентов, которым вы выполнили замену аортального клапана. У половины этих пациентов вы также выполнили аортокоронарное шунтирование (АКШ), либо вблизи времени операции по замене аортального клапана, либо одновременно. Речь идёт о пациентах старше 80 лет.\nДоктор Антон Титов, MD: Что вы узнали из своего очень большого опыта о кардиохирургии у пожилых пациентов? Какой подход является наилучшим, как вы на практике подходите к замене аортального клапана у пациентов старше 80 лет?\nДоктор Юрген Энкер, MD: Во-первых, мы должны различать биологический возраст и хронологический возраст, потому что есть пациенты, которые биологически значительно моложе и лучше подготовлены к кардиохирургической операции. Во-вторых, всегда необходимо прислушиваться к пациенту. Если пациент говорит: «Я слишком стар, это не для меня», не следует принуждать пациента к какой-либо операции. Пациент должен хотеть эту операцию и следовать рекомендациям по послеоперационному уходу. Им необходимо откашливаться, дышать и мобилизоваться для достижения адекватного результата.\nДоктор Юрген Энкер, MD: Мы также должны учитывать факторы риска. Если пациенту почти 90 лет, у него были предыдущие операции, низкий сердечный выброс или заболевание почек, хирургическое вмешательство может не быть адекватным решением. К счастью, для пациентов, неоперабельных с помощью традиционной хирургии, у нас есть методика TAVI. Мы можем установить катетер через паховую область, провести клапан к аортальному кольцу пациента и заменить клапан без обычной операции, только с помощью катетерной процедуры.\nДоктор Юрген Энкер, MD: Это широко применяется в Германии в настоящее время. Около 50% пациентов оперируются интервенционно с помощью процедуры TAVI, а другая половина подвергается традиционной операции. Пациентам старше 80 лет необходимо определиться, поскольку, например, ожидаемая продолжительность жизни 80-летнего мужчины в Германии составляет 6,9 лет, а женщины — около 8 лет. Без такой операции они потеряют несколько лет качественной жизни.\nДоктор Юрген Энкер, MD: Так что это очень важно. Это не только вопрос биологического возраста, но и вопрос функциональной подготовки пациента и психологического желания перенести операцию для получения более высокого качества жизни.\nДоктор Антон Титов, MD: Абсолютно верно! У нас есть так называемый индекс хрупкости, который измеряет способность пациента перенести такую операцию и уровень его функциональной подготовки, и это очень важно.","image":"https:\/\/diagnosticdetectives.ru\/cdn\/shop\/products\/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.006.jpg?v=1660896322\u0026width=1920","name":"\u003c!DOCTYPE html\u003e\n\u003chtml lang=\"ru\"\u003e\n\u003chead\u003e\n \u003cmeta charset=\"UTF-8\"\u003e\n \u003cmeta name=\"viewport\" content=\"width=device-width, initial-scale=1.0\"\u003e\n \u003ctitle\u003eЗамена аортального клапана","offers":{"@id":"\/products\/aortic-valve-replacement-in-elderly-patients?variant=41852068233372#offer","@type":"Offer","availability":"http:\/\/schema.org\/InStock","price":"0.00","priceCurrency":"RUB","url":"https:\/\/diagnosticdetectives.ru\/products\/aortic-valve-replacement-in-elderly-patients?variant=41852068233372"},"url":"https:\/\/diagnosticdetectives.ru\/products\/aortic-valve-replacement-in-elderly-patients"} </script> </div><section id="shopify-section-template--18622507942044__product_expert_masterclass_teaser_GQjD4Q" class="shopify-section index-section"> <section class="section section--tight" data-section-id="template--18622507942044__product_expert_masterclass_teaser_GQjD4Q"> <div class="page-width"><div class="emc"> <a href="/pages/expert-masterclass/dr-juergen-ennker" class="emc__media" style="--emc-max-w: 960px; 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padding-bottom: 56.25%;" > <is-land on:visible data-image-type=""><img src="//diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.007.jpg?v=1660896336&width=1080" alt="" srcset="//diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.007.jpg?v=1660896336&width=360 360w, //diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.007.jpg?v=1660896336&width=540 540w, //diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.007.jpg?v=1660896336&width=720 720w, //diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.007.jpg?v=1660896336&width=900 900w, //diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.007.jpg?v=1660896336&width=1080 1080w" width="1080" height="607.5" loading="lazy" class="grid-product__image image-element" sizes="30vw" data-animate="fadein"> </is-land> </div></div> <div class="grid-item__meta"> <div class="grid-item__meta-main"><div class="grid-product__title">Замена аортального клапана. Свиной или бычий аортальный клапан. Или механический аортальный клапан. Как выбрать? 3</div></div> <div class="grid-item__meta-secondary"> <div class="grid-product__price"><span class="grid-product__price--current"> <span aria-hidden="true">руб0,00</span> <span class="visually-hidden">руб0,00</span> </span></div> </div></div> </a></div> </div> </div> <div class=" grid-item grid-product grid-product-image-breathing-room--true " > <div class="product-grid-item" data-product-handle="aortic-valve-replacement-how-to-choose-correct-method-1-copy" data-product-id="8488950268060" data-product-grid-item > <div class="grid-item__content"><div class="grid-product__actions"> <is-land on:idle> <quick-shop defer-hydration> <tool-tip-trigger class="tool-tip-trigger" data-tool-tip="QuickShop" data-tool-tip-classes="quick-shop-modal" defer-hydration > <span class="tool-tip-trigger__content" data-tool-tip-trigger-content="" > </span> <button type="button" class="btn btn--circle btn--icon quick-product__btn js-modal-open-quick-modal-8488950268060 small--hide" title=" Quick shop " data-handle="aortic-valve-replacement-how-to-choose-correct-method-1-copy"> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-search icon--line" viewbox="0 0 64 64" width="20" height="20" > <path d="M47.16 28.58A18.58 18.58 0 1 1 28.58 10a18.58 18.58 0 0 1 18.58 18.58M54 54 41.94 42" stroke-miterlimit="10" fill="none" stroke="currentColor" /> </svg> <span class="icon__fallback-text visually-hidden"> Quick shop </span> </button> </tool-tip-trigger> <script type="module"> import 'components/tool-tip-trigger' </script> </quick-shop> <template data-island> <script type="module"> import 'components/quick-shop' </script> </template> </is-land> </div><a href="/collections/heart-valve-aortic-mitral-tricuspid/products/aortic-valve-replacement-how-to-choose-correct-method-1-copy" class="grid-item__link"> <div class="grid-product__image-wrap"> <div class="grid-product__tags"></div><div style="height: 0; padding-bottom: 56.25%;" > <is-land on:visible data-image-type=""><img src="//diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.004.jpg?v=1660896307&width=1080" alt="" srcset="//diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.004.jpg?v=1660896307&width=360 360w, //diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.004.jpg?v=1660896307&width=540 540w, //diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.004.jpg?v=1660896307&width=720 720w, //diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.004.jpg?v=1660896307&width=900 900w, //diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.004.jpg?v=1660896307&width=1080 1080w" width="1080" height="607.5" loading="lazy" class="grid-product__image image-element" sizes="30vw" data-animate="fadein"> </is-land> </div></div> <div class="grid-item__meta"> <div class="grid-item__meta-main"><div class="grid-product__title">Замена аортального клапана. Как выбрать оптимальный метод? 1 (Копия)</div></div> <div class="grid-item__meta-secondary"> <div class="grid-product__price"><span class="grid-product__price--current"> <span aria-hidden="true">руб0,00</span> <span class="visually-hidden">руб0,00</span> </span></div> </div></div> </a></div> </div> </div> <div class=" grid-item grid-product grid-product-image-breathing-room--true " > <div class="product-grid-item" data-product-handle="right-sided-heart-failure-right-ventricular-failure-is-a-problem-to-diagnose-and-to-treat-correctly-7" data-product-id="7374950400156" data-product-grid-item > <div class="grid-item__content"><div class="grid-product__actions"> <is-land on:idle> <quick-shop defer-hydration> <tool-tip-trigger class="tool-tip-trigger" data-tool-tip="QuickShop" data-tool-tip-classes="quick-shop-modal" defer-hydration > <span class="tool-tip-trigger__content" data-tool-tip-trigger-content="" > </span> <button type="button" class="btn btn--circle btn--icon quick-product__btn js-modal-open-quick-modal-7374950400156 small--hide" title=" Quick shop " data-handle="right-sided-heart-failure-right-ventricular-failure-is-a-problem-to-diagnose-and-to-treat-correctly-7"> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-search icon--line" viewbox="0 0 64 64" width="20" height="20" > <path d="M47.16 28.58A18.58 18.58 0 1 1 28.58 10a18.58 18.58 0 0 1 18.58 18.58M54 54 41.94 42" stroke-miterlimit="10" fill="none" stroke="currentColor" /> </svg> <span class="icon__fallback-text visually-hidden"> Quick shop </span> </button> </tool-tip-trigger> <script type="module"> import 'components/tool-tip-trigger' </script> </quick-shop> <template data-island> <script type="module"> import 'components/quick-shop' </script> </template> </is-land> </div><a href="/collections/heart-valve-aortic-mitral-tricuspid/products/right-sided-heart-failure-right-ventricular-failure-is-a-problem-to-diagnose-and-to-treat-correctly-7" class="grid-item__link"> <div class="grid-product__image-wrap"> <div class="grid-product__tags"></div><div style="height: 0; padding-bottom: 56.25%;" > <is-land on:visible data-image-type=""><img src="//diagnosticdetectives.ru/cdn/shop/products/Dr_Aaron_Waxman_Diagnostic_Detectives_Network_Medical-Second_Opinion_Shortness-of-breath-diagnosis-Pulmonary-arterial-hypertension-treatment-options.008.jpg?v=1660993568&width=1080" alt="" srcset="//diagnosticdetectives.ru/cdn/shop/products/Dr_Aaron_Waxman_Diagnostic_Detectives_Network_Medical-Second_Opinion_Shortness-of-breath-diagnosis-Pulmonary-arterial-hypertension-treatment-options.008.jpg?v=1660993568&width=360 360w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Aaron_Waxman_Diagnostic_Detectives_Network_Medical-Second_Opinion_Shortness-of-breath-diagnosis-Pulmonary-arterial-hypertension-treatment-options.008.jpg?v=1660993568&width=540 540w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Aaron_Waxman_Diagnostic_Detectives_Network_Medical-Second_Opinion_Shortness-of-breath-diagnosis-Pulmonary-arterial-hypertension-treatment-options.008.jpg?v=1660993568&width=720 720w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Aaron_Waxman_Diagnostic_Detectives_Network_Medical-Second_Opinion_Shortness-of-breath-diagnosis-Pulmonary-arterial-hypertension-treatment-options.008.jpg?v=1660993568&width=900 900w, //diagnosticdetectives.ru/cdn/shop/products/Dr_Aaron_Waxman_Diagnostic_Detectives_Network_Medical-Second_Opinion_Shortness-of-breath-diagnosis-Pulmonary-arterial-hypertension-treatment-options.008.jpg?v=1660993568&width=1080 1080w" width="1080" height="607.5" loading="lazy" class="grid-product__image image-element" sizes="30vw" data-animate="fadein"> </is-land> </div></div> <div class="grid-item__meta"> <div class="grid-item__meta-main"><div class="grid-product__title">Правожелудочковая сердечная недостаточность. Диагностика и лечение данной патологии сопряжены со значительными трудностями. 7</div></div> <div class="grid-item__meta-secondary"> <div class="grid-product__price"><span class="grid-product__price--current"> <span aria-hidden="true">руб0,00</span> <span class="visually-hidden">руб0,00</span> </span></div> </div></div> </a></div> </div> </div> </div> </div> </div> </div> </div><div id="shopify-section-template--18622507942044__more-products-vendor" class="shopify-section"> <is-land on:visible> <vendor-products data-subsection data-section-id="template--18622507942044__more-products-vendor" data-section-type="vendor-products" data-product-id="7374914289820" data-vendor-url="/collections/vendors?q=Diagnostic%20Detectives%20Network" data-max-products="3" > <div class="index-section index-section--sub-product"> <div class="page-width"> <header class="section-header"> <div class="h3 section-header__title"> More from <a href="/collections/vendors?q=Diagnostic%20Detectives%20Network" title="Diagnostic Detectives Network">Diagnostic Detectives Network</a> </div> </header> </div> <div class="page-width page-width--flush-small"> <div id="VendorProducts-template--18622507942044__more-products-vendor" class="new-grid product-grid scrollable-grid--small" data-view="medium" > <div class="visually-invisible"> <div class=" grid-item grid-product grid-product-image-breathing-room--true " > <div class="product-grid-item" data-product-handle="aortic-valve-replacement-in-elderly-patients" data-product-id="7374914289820" data-product-grid-item > <div class="grid-item__content"><div class="grid-product__actions"> <is-land on:idle> <quick-shop defer-hydration> <tool-tip-trigger class="tool-tip-trigger" data-tool-tip="QuickShop" data-tool-tip-classes="quick-shop-modal" defer-hydration > <span class="tool-tip-trigger__content" data-tool-tip-trigger-content="" > </span> <button type="button" class="btn btn--circle btn--icon quick-product__btn js-modal-open-quick-modal-7374914289820 small--hide" title=" Quick shop " data-handle="aortic-valve-replacement-in-elderly-patients"> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon-search icon--line" viewbox="0 0 64 64" width="20" height="20" > <path d="M47.16 28.58A18.58 18.58 0 1 1 28.58 10a18.58 18.58 0 0 1 18.58 18.58M54 54 41.94 42" stroke-miterlimit="10" fill="none" stroke="currentColor" /> </svg> <span class="icon__fallback-text visually-hidden"> Quick shop </span> </button> </tool-tip-trigger> <script type="module"> import 'components/tool-tip-trigger' </script> </quick-shop> <template data-island> <script type="module"> import 'components/quick-shop' </script> </template> </is-land> </div><a href="/collections/heart-valve-aortic-mitral-tricuspid/products/aortic-valve-replacement-in-elderly-patients" class="grid-item__link"> <div class="grid-product__image-wrap"> <div class="grid-product__tags"></div><div style="height: 0; padding-bottom: 56.25%;" > <is-land on:visible data-image-type=""><img src="//diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.006.jpg?v=1660896322&width=1080" alt="" srcset="//diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.006.jpg?v=1660896322&width=360 360w, //diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.006.jpg?v=1660896322&width=540 540w, //diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.006.jpg?v=1660896322&width=720 720w, //diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.006.jpg?v=1660896322&width=900 900w, //diagnosticdetectives.ru/cdn/shop/products/Aortic-Stenosis-Valve-Surgery-Second-Opinion-Dr-Juergen-Ennker_Medical_Second_Opinion_Diagnostic_Detectives_Network.006.jpg?v=1660896322&width=1080 1080w" width="1080" height="607.5" loading="lazy" class="grid-product__image image-element" sizes="30vw" data-animate="fadein"> </is-land> </div></div> <div class="grid-item__meta"> <div class="grid-item__meta-main"><div class="grid-product__title"><!DOCTYPE html> <html lang="ru"> <head> <meta charset="UTF-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <title>Замена аортального клапана</div></div> <div class="grid-item__meta-secondary"> <div class="grid-product__price"><span class="grid-product__price--current"> <span aria-hidden="true">руб0,00</span> <span class="visually-hidden">руб0,00</span> </span></div> </div></div> </a></div> </div> </div> </div> </div> </div> </div> </vendor-products> <template data-island> <script type="module"> import 'components/section-more-products-vendor' </script> </template> </is-land> </div><div id="shopify-section-template--18622507942044__collection-return" class="shopify-section"> <div class="return-section color-scheme-none"><div class="page-width text-center"> <a href="/collections/heart-valve-aortic-mitral-tricuspid" class="btn return-link" > <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon--wide icon-arrow-left" viewbox="0 0 50 15" fill="currentColor" width="20" height="20" > <path d="M50 5.38v4.25H15V15L0 7.5 15 0v5.38Z" /> </svg> Back to Клапан сердца [аортальный, митральный, трехстворчатый] </a> </div> </div> </div><div id="shopify-section-template--18622507942044__featured_product_LHGeFD" class="shopify-section index-section"> <section class="page-content page-content--product page-content--partial" data-section-id="template--18622507942044__featured_product_LHGeFD" data-product-id="7374955085980" > <div class="page-width"> <div class="product-grid__container product--images float-grid grid--product-images--partial clearfix"><div class="grid__item medium-up--one-half product-single__sticky"> <product-images data-product-images data-zoom="false" data-has-slideshow="false" data-media-gallery-layout="" data-modal="false" data-product-id="7374955085980" data-section-id="template--18622507942044__featured_product_LHGeFD" > <div class="product__photos product__photos-template--18622507942044__featured_product_LHGeFD product__photos--beside"> <div class="product__main-photos" data-product-single-media-group> <div data-product-photos data-zoom="false" class="product-slideshow" id="ProductPhotos-template--18622507942044__featured_product_LHGeFD" > <div class="product-main-slide starting-slide" data-index="0" data-media-id="26893580828828" > <div data-product-image-main class="product-image-main" ><div class="image-wrap hide" style="height: 0; padding-bottom: 41.666666666666664%;" > <is-land on:visible data-image-type="photoswipe"> <img src="//diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002.jpg?v=1666367638&width=1080" alt="Уточните план лечения, проконсультировавшись с ведущими специалистами, которые полностью соответствуют вашему клиническому случаю." srcset="//diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002.jpg?v=1666367638&width=360 360w, //diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002.jpg?v=1666367638&width=540 540w, //diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002.jpg?v=1666367638&width=720 720w, //diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002.jpg?v=1666367638&width=900 900w, //diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002.jpg?v=1666367638&width=1080 1080w" width="1080" height="450.0" loading="eager" class=" image-element" data-photoswipe-src="//diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002.jpg?v=1666367638&width=1800" data-photoswipe-width="1920" data-photoswipe-height="800" data-index="1" sizes=" (min-width: 769px) 50vw, 75vw" data-animate="none"> </is-land> </div><div class="product__video-wrapper"> <is-land on:idle> <div class="video-media aspect-ratio--16-9" data-background="false" ><video-media defer-hydration > <video playsinline="true" controls="controls" preload="metadata" aria-label="Уточните план лечения, проконсультировавшись с ведущими специалистами, которые полностью соответствуют вашему клиническому случаю." poster="//diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002_500x.jpg?v=1666367638"><source src="//diagnosticdetectives.ru/cdn/shop/videos/c/vp/a22b0d50e4c64d9c8b0a558888197f4a/a22b0d50e4c64d9c8b0a558888197f4a.HD-720p-4.5Mbps-8813343.mp4?v=0" type="video/mp4"><img src="//diagnosticdetectives.ru/cdn/shop/products/Experts_Diagnostic_Detectives_Network_MD_PhDcopy.002_500x.jpg?v=1666367638"></video> </video-media></div> <template data-island> <script type="module"> import 'components/video-media' </script> </template> </is-land> </div></div> </div> </div></div> <div data-product-thumbs class="product__thumbs product__thumbs--beside product__thumbs-placement--left medium-up--hide small--hide" data-position="beside" data-arrows="false" ><div class="product__thumbs--scroller"></div></div> </div> <script type="application/json" data-current-variant-json>{"id":41852130001052,"title":"Default Title","option1":"Default Title","option2":null,"option3":null,"sku":"","requires_shipping":false,"taxable":false,"featured_image":null,"available":true,"name":"Уточните план лечения, проконсультировавшись с ведущими специалистами, которые полностью соответствуют вашему клиническому случаю.","public_title":null,"options":["Default Title"],"price":0,"weight":0,"compare_at_price":null,"inventory_management":null,"barcode":"","requires_selling_plan":false,"selling_plan_allocations":[]}</script> <script type="application/json" data-product-options-json>["Title"]</script> </product-images> <script type="module"> import 'components/product-images' </script> <script type="application/json" id="ModelJson-template--18622507942044__featured_product_LHGeFD"> [] </script><div class="localized-video-iframe-container" style="margin-top: 1.5rem;"> <div id="language-selector-wrapper"> <label for="language-selector">🎧 Select dubbed video language:</label> <select id="language-selector"> <option value="">Choose dubbed language</option> <option value="de" >Deutsch</option> <option value="fr" >Français</option> <option value="ru" selected>Русский</option> <option value="it" >Italiano</option> <option value="es" >Español</option> <option value="pt" >Português</option> <option value="ar" >العربية</option> <option value="zh" >中文</option> <option value="ja" >日本語</option> <option value="ko" >한국어</option> </select> </div> <iframe id="localized-video-iframe" src="https://player.vimeo.com/video/1113043591?autoplay=0&title=0&byline=0&portrait=0" data-selected-lang="ru" frameborder="0" allow="autoplay; fullscreen" allowfullscreen loading="lazy" style="width:100%; aspect-ratio:16/9; margin-top: 0.5rem;"> </iframe> </div></div><div class="product-grid__content product--description product-single__sticky grid__item medium-up--one-half"> <div class="product-single__meta"> <div class="product-block" data-section-id="template--18622507942044__featured_product_LHGeFD" > <h1 class="h2 product-single__title">Уточните план лечения, проконсультировавшись с ведущими специалистами, которые полностью соответствуют вашему клиническому случаю.</h1></div> <div class="product-block" > <a class="custom-white-button" href="/pages/how-it-works" target="_self" rel="noopener noreferrer"> Can we help? </a> <style> .custom-white-button { background-color: transparent !important; color: #ffffff !important; border: 2px solid #ffffff !important; font-size: 18px !important; padding: 10px 20px !important; text-align: center !important; display: inline-block !important; text-decoration: none !important; } .custom-white-button:hover { background-color: #ff0000 !important; color: #ffffff !important; } </style> </div> </div> </div></div> </div> </section> <script> document.addEventListener("DOMContentLoaded", function () { const selector = document.getElementById("language-selector"); const iframe = document.getElementById("localized-video-iframe"); if (!selector || !iframe) return; // 🧠 Detect the language used in video (via data attribute from Liquid) const loadedLang = iframe.getAttribute("data-selected-lang"); if (loadedLang) { selector.value = loadedLang; } // 🧠 On dropdown change, switch video selector.addEventListener("change", function () { const lang = selector.value; if (!lang) return; const metafieldUrl = {"vimeo_url_ar":"https:\/\/player.vimeo.com\/video\/1113042680","vimeo_url_de":"https:\/\/player.vimeo.com\/video\/1113042888","vimeo_url_es":"https:\/\/player.vimeo.com\/video\/1113043009","vimeo_url_fr":"https:\/\/player.vimeo.com\/video\/1113043115","vimeo_url_it":"https:\/\/player.vimeo.com\/video\/1113043209","vimeo_url_ja":"https:\/\/player.vimeo.com\/video\/1113043318","vimeo_url_ko":"https:\/\/player.vimeo.com\/video\/1113043403","vimeo_url_pt":"https:\/\/player.vimeo.com\/video\/1113043502","vimeo_url_ru":"https:\/\/player.vimeo.com\/video\/1113043591","vimeo_url_zh":"https:\/\/player.vimeo.com\/video\/1113042779"}; const urlKey = "vimeo_url_" + lang; const newUrl = metafieldUrl[urlKey]; if (newUrl) { iframe.src = newUrl + "?autoplay=0&title=0&byline=0&portrait=0"; } }); }); </script> </div><div id="shopify-section-template--18622507942044__featured_product_ik9hhY" class="shopify-section index-section"> <section class="page-content page-content--product page-content--partial" data-section-id="template--18622507942044__featured_product_ik9hhY" data-product-id="7374955151516" > <div class="page-width"> <div class="product-grid__container product--images float-grid grid--product-images-right grid--product-images--partial clearfix"><div class="product-grid__content product--description product-single__sticky grid__item medium-up--one-half"> <div class="product-single__meta"> <div class="product-block" data-section-id="template--18622507942044__featured_product_ik9hhY" > <h1 class="h2 product-single__title">Подбор идеальных хирургов или медицинских специалистов для проведения вашего лечения.</h1></div> <div class="product-block" > <a class="custom-white-button" href="/pages/how-it-works" target="_self" rel="noopener noreferrer"> Can we help? </a> <style> .custom-white-button { background-color: transparent !important; color: #ffffff !important; border: 2px solid #ffffff !important; font-size: 18px !important; padding: 10px 20px !important; text-align: center !important; display: inline-block !important; text-decoration: none !important; } .custom-white-button:hover { background-color: #ff0000 !important; color: #ffffff !important; } </style> </div> </div> </div><div class="grid__item medium-up--one-half product-single__sticky"> <product-images data-product-images data-zoom="false" data-has-slideshow="false" data-media-gallery-layout="" data-modal="false" data-product-id="7374955151516" data-section-id="template--18622507942044__featured_product_ik9hhY" > <div class="product__photos product__photos-template--18622507942044__featured_product_ik9hhY product__photos--beside"> <div class="product__main-photos" data-product-single-media-group> <div data-product-photos data-zoom="false" class="product-slideshow" id="ProductPhotos-template--18622507942044__featured_product_ik9hhY" > <div class="product-main-slide starting-slide" data-index="0" data-media-id="26893628440732" > <div data-product-image-main class="product-image-main" ><div class="image-wrap hide" style="height: 0; 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const iframe = document.getElementById("localized-video-iframe"); if (!selector || !iframe) return; // 🧠 Detect the language used in video (via data attribute from Liquid) const loadedLang = iframe.getAttribute("data-selected-lang"); if (loadedLang) { selector.value = loadedLang; } // 🧠 On dropdown change, switch video selector.addEventListener("change", function () { const lang = selector.value; if (!lang) return; const metafieldUrl = {}; const urlKey = "vimeo_url_" + lang; const newUrl = metafieldUrl[urlKey]; if (newUrl) { iframe.src = newUrl + "?autoplay=0&title=0&byline=0&portrait=0"; } }); }); </script> </div><div id="shopify-section-template--18622507942044__sub" class="shopify-section product-full-width"> <div class="page-width page-width--narrow"> <div class="product-block" > <at-rte class="at-rte rte clearfix"> <h1>Варианты замены аортального клапана у пациентов пожилого возраста</h1> <h2>Перейти к разделу</h2> <ul> <li><a href="#biological-age-vs-numerical-age">Биологический возраст vs. хронологический возраст</a></li> <li><a href="#importance-of-patient-consent">Важность информированного согласия пациента</a></li> <li><a href="#risk-factors-in-elderly-surgery">Факторы риска при хирургических вмешательствах у пожилых</a></li> <li><a href="#transcatheter-aortic-valve-implantation">Транскатетерная имплантация аортального клапана</a></li> <li><a href="#frailty-index-and-quality-of-life">Индекс хрупкости и качество жизни</a></li> <li><a href="#full-transcript">Полная расшифровка</a></li> </ul> <h2 id="biological-age-vs-numerical-age">Биологический возраст vs. хронологический возраст</h2> <p><meta charset="utf-8"/>Доктор Юрген Энкер, MD, подчёркивает важность разграничения биологического и хронологического возраста при рассмотрении замены аортального клапана у пожилых пациентов. Биологический возраст отражает физическое состояние и функциональную подготовленность пациента, что существенно влияет на возможность проведения операции. Некоторые пациенты старше 80 лет могут быть биологически моложе и лучше подготовлены к кардиохирургическим вмешательствам, что делает их более подходящими кандидатами для операции.</p> <h2 id="importance-of-patient-consent">Важность информированного согласия пациента</h2> <p><meta charset="utf-8"/>Доктор Юрген Энкер, MD, акцентирует важность добровольного согласия и готовности пациента при принятии решения о замене аортального клапана. Пациенты должны выражать желание на проведение операции и быть готовыми следовать послеоперационным рекомендациям, таким как дыхательная гимнастика и мобилизация. Психологическая готовность и мотивация пациента имеют решающее значение для успешного исхода операции.</p> <h2 id="risk-factors-in-elderly-surgery">Факторы риска при хирургических вмешательствах у пожилых</h2> <p><meta charset="utf-8"/>Доктор Юрген Энкер, MD, выделяет несколько факторов риска, которые необходимо учитывать перед проведением операции у пожилых пациентов. К ним относятся предшествующие операции, низкий сердечный выброс и заболевания почек. Для пациентов, приближающихся к 90-летнему возрасту с выраженными факторами риска, традиционная хирургия может не быть оптимальным вариантом. Оценка этих рисков необходима для обеспечения безопасности пациента и оптимизации результатов лечения.</p> <h2 id="transcatheter-aortic-valve-implantation">Транскатетерная имплантация аортального клапана</h2> <p>Для пациентов, непригодных для традиционной хирургии, <meta charset="utf-8"/>доктор Юрген Энкер обсуждает преимущества транскатетерной имплантации аортального клапана (TAVI). Это малоинвазивное вмешательство предполагает установку катетера через паховую область для замены аортального клапана, что исключает необходимость открытой операции на сердце. TAVI представляет собой жизнеспособную альтернативу для пациентов высокого риска, причём примерно 50% пожилых пациентов в Германии проходят эту процедуру.</p> <h2 id="frailty-index-and-quality-of-life">Индекс хрупкости и качество жизни</h2> <p>Индекс хрупкости является ключевым инструментом оценки способности пациента перенести операцию и общего уровня функциональной подготовки. <meta charset="utf-8"/>Доктор Юрген Энкер поясняет, что этот индекс помогает определить вероятность успешного исхода и улучшения качества жизни после операции. Для пожилых пациентов замена аортального клапана может значительно продлить ожидаемую продолжительность жизни и улучшить её качество, что делает эту процедуру ценной для тех, кто функционально подготовлен и мотивирован.</p> <h2 id="full-transcript">Полная расшифровка</h2> <p><strong><meta charset="utf-8"/>Доктор Антон Титов, MD:</strong> Давайте обсудим замену аортального клапана у пациентов пожилого возраста. У вас очень обширный опыт, включающий публикацию серии из 493 последовательных пожилых пациентов, которым вы выполнили замену аортального клапана. У половины этих пациентов вы также выполнили аортокоронарное шунтирование (АКШ), либо вблизи времени операции по замене аортального клапана, либо одновременно. Речь идёт о пациентах старше 80 лет.</p> <p><strong><meta charset="utf-8"/>Доктор Антон Титов, MD:</strong> Что вы узнали из своего очень большого опыта о кардиохирургии у пожилых пациентов? Какой подход является наилучшим, как вы на практике подходите к замене аортального клапана у пациентов старше 80 лет?</p> <p><strong><meta charset="utf-8"/>Доктор Юрген Энкер, MD:</strong> Во-первых, мы должны различать биологический возраст и хронологический возраст, потому что есть пациенты, которые биологически значительно моложе и лучше подготовлены к кардиохирургической операции. Во-вторых, всегда необходимо прислушиваться к пациенту. Если пациент говорит: «Я слишком стар, это не для меня», не следует принуждать пациента к какой-либо операции. Пациент должен хотеть эту операцию и следовать рекомендациям по послеоперационному уходу. Им необходимо откашливаться, дышать и мобилизоваться для достижения адекватного результата.</p> <p><strong><meta charset="utf-8"/>Доктор Юрген Энкер, MD:</strong> Мы также должны учитывать факторы риска. Если пациенту почти 90 лет, у него были предыдущие операции, низкий сердечный выброс или заболевание почек, хирургическое вмешательство может не быть адекватным решением. К счастью, для пациентов, неоперабельных с помощью традиционной хирургии, у нас есть методика TAVI. Мы можем установить катетер через паховую область, провести клапан к аортальному кольцу пациента и заменить клапан без обычной операции, только с помощью катетерной процедуры.</p> <p><strong><meta charset="utf-8"/>Доктор Юрген Энкер, MD:</strong> Это широко применяется в Германии в настоящее время. Около 50% пациентов оперируются интервенционно с помощью процедуры TAVI, а другая половина подвергается традиционной операции. Пациентам старше 80 лет необходимо определиться, поскольку, например, ожидаемая продолжительность жизни 80-летнего мужчины в Германии составляет 6,9 лет, а женщины — около 8 лет. Без такой операции они потеряют несколько лет качественной жизни.</p> <p><strong><meta charset="utf-8"/>Доктор Юрген Энкер, MD:</strong> Так что это очень важно. Это не только вопрос биологического возраста, но и вопрос функциональной подготовки пациента и психологического желания перенести операцию для получения более высокого качества жизни.</p> <p><strong><meta charset="utf-8"/>Доктор Антон Титов, MD:</strong> Абсолютно верно! У нас есть так называемый индекс хрупкости, который измеряет способность пациента перенести такую операцию и уровень его функциональной подготовки, и это очень важно.</p> </at-rte> <script type="module"> import 'components/rte' </script> </div> </div> </div> </main> <div id="shopify-section-sections--18523926593692__footer" class="shopify-section shopify-section-group-footer-group"> <div class="footer__section footer__section--border"> <div class="page-width"> <div class="footer__newsletter"><div class="footer__subscribe rte rte--nomargin clearfix"> <p><strong>Get high-impact health ideas [1x month]</strong></p> </div> <form method="post" action="/contact#newsletter-sections--18523926593692__footer" id="newsletter-sections--18523926593692__footer" accept-charset="UTF-8" class="contact-form"><input type="hidden" name="form_type" value="customer" /><input type="hidden" name="utf8" value="✓" /> <label for="Email-sections--18523926593692__footer" class="visually-hidden"> Enter your email </label> <label for="newsletter-form-submit-sections--18523926593692__footer" class="visually-hidden"> Subscribe </label> <input type="hidden" name="contact[tags]" value="prospect,newsletter"> <input type="hidden" name="contact[context]" value="footer"> <div class="input-group newsletter__input-group"> <input type="email" value="" placeholder=" Enter your email " name="contact[email]" id="Email-sections--18523926593692__footer" class="input-group-field newsletter__input" autocorrect="off" autocapitalize="off" required > <div class="input-group-btn"> <button type="submit" id="newsletter-form-submit-sections--18523926593692__footer" class="btn" name="commit" aria-label=" Subscribe " > <span class="form__submit--large"> Subscribe </span> <span class="form__submit--small"> <svg xmlns="http://www.w3.org/2000/svg" aria-hidden="true" focusable="false" role="presentation" class="icon icon--wide icon-arrow-right" viewbox="0 0 50 15" fill="currentColor" width="20" height="20" > <path d="M0 9.63V5.38h35V0l15 7.5L35 15V9.63Z" /> </svg> </span> </button> </div> </div></form> </div> </div> </div> <div id="FooterMobileNavWrap" class="footer__section footer__section--border medium-up--hide"> <div id="FooterMobileNav" class="page-width"></div> </div><is-land on:visible> <footer-section class="site-footer" data-section-id="sections--18523926593692__footer" data-section-type="footer-section"> <div id="FooterMenus" class="footer__section footer__section--menus " > <div class="page-width"> <div class="footer__blocks"><div class="footer__block footer__block--menu" data-type="menu" > <h2 class="footer__title h4"> About us </h2> <ul class="footer__menu"><li> <a href="/pages/our-mission-story">About us. 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