ABSTRACT
The results of surgical aid delivery to adult patients, suffering inborn heart failures (IHF), were analyzed for period of 15 yrs. Surgical activity in teenagers and adult patients, suffering IHF, was analyzed with the objective to create a management strategy for such patients. More close dispensary control of teenagers in a pediatrician-cardiologist was noted, while their transfer to the adult clinic it is necessary to follow them thoroughly together with dispensary registration. Progressive enhancement of the patients quantity was registered, in whom more complex and combined inborn anomalies of the heart and the main vessels were diagnosed. Enhancement of the interventions quantity, which are performed on the exit tract of left ventricle and ascending aorta and what is caused by introduction of angiographic interventions, was noted together with total rising of the operations quantity.
Subject(s)
Cardiovascular Surgical Procedures/statistics & numerical data , Delivery of Health Care/methods , Heart Defects, Congenital/surgery , Adolescent , Adult , Delivery of Health Care/standards , Delivery of Health Care/statistics & numerical data , Heart Defects, Congenital/diagnosis , Heart Defects, Congenital/mortality , Humans , Medical Records Systems, Computerized , Retrospective Studies , Ukraine , Young AdultABSTRACT
Opinion varies among surgeons regarding the preferable method of surgical correction in patients with transposition of the great vessels (TGV) presenting with abnormal origins of the coronary artery (CA) and inadequacies in the diameters of the great vessels. In the work presented, the experience is analyzed gained with the performing of TGV radical correction operations of the arterial switch type in patients presenting with anomalous CA origins and abnormalities in diameters of the great vessels (n = 5). The submitted option permits simplifying CA transfer avoiding the coronary blood flow-related fatal intraoperative complications. Our modification of creation of a "new" aorta combined with particular features of implantation of the coronary arteries enabled us to secure good results in the presence of malformed, TGV, anatomy, which fact allowed the arterial switch operations to be extended to a greater number of cases in disadvantageous anatomical variants of TGV.
Subject(s)
Aorta/surgery , Coronary Vessels/transplantation , Transposition of Great Vessels/surgery , Cardiovascular Surgical Procedures/methods , Extracorporeal Circulation , Heart Arrest, Induced , Humans , Infant , Infant, Newborn , Postoperative Complications/epidemiologyABSTRACT
The experience of the peritoneal dialysis (PD) successful application in 16 children of an early age was summarized. In all the patients the terminal state with an acute cardiac and renal insufficiency was noted after cardiosurgical operation conduction using artificial blood circulation. The improvement of hemodynamical indices, renal and pulmonary function as well, were promoted by an early application of PD.
Subject(s)
Cardiac Surgical Procedures/methods , Heart Defects, Congenital/surgery , Peritoneal Dialysis/methods , Child, Preschool , Heart Defects, Congenital/mortality , Humans , Infant , Infant, Newborn , Renal Insufficiency/surgery , Survival RateABSTRACT
The possibility of early extubation of the first year of life children after surgical correction of congenital heart diseases while artificial blood circulation conduction was studied. For the 1996-1999 period surgical treatment was conducted in 381 patients aged at average (5.71 +/- 3.17) month, body mass at average (5.77 +/- 1.8) kg. 163 (42.7%) patients were converted to independent respiration in 6-12 hours after operation, satisfactory clinical state and indexes of gas exchange were in 122 (74.8%), 8 patients needed reintubation. Early extubation permit to reduce of respiratory complications frequency, duration of treatment in intensive therapy unit.
Subject(s)
Cardiac Surgical Procedures/methods , Extracorporeal Circulation/methods , Intubation, Intratracheal/methods , Postoperative Care , Ventilator Weaning/methods , Blood Gas Analysis , Critical Care , Humans , Infant , Infant, Newborn , Intubation , Respiration Disorders/prevention & control , Severity of Illness Index , Time FactorsABSTRACT
The analysis of the coronary arteries (CA) morphology in the main vessels transposition (MVT) cases was presented, basing on the clinical and cadaveric investigations data. During performance of 88 operations there were revealed 8 different morphological variants of the CA branching. There were studied 8 heart macropreparations with MVT and there were disclosed 4 different types of the CA morphology.
Subject(s)
Coronary Vessels/anatomy & histology , Transposition of Great Vessels/surgery , Humans , Retrospective StudiesABSTRACT
From 1992 till 2000 yr 70 patients were operated on in the clinic for the main vessels transposition (MVT) using method of Senning. In the principal group 53 patients were incorporated suffering MVT with unchanged interventricular septum (IVS) and with its minimal defect as well. The IVS defect and concurrent anomalies were revealed in 17 patients. Hospital mortality was 38.4%. In the 3.8 yrs follow-up period at average all the patients were alive, in majority of them satisfactory function of right systemic ventriculus was noted.
Subject(s)
Cardiac Surgical Procedures/methods , Transposition of Great Vessels/surgery , Heart Atria/abnormalities , Heart Atria/surgery , Hemodynamics , HumansABSTRACT
The article presents the first experience gained with the use of the Lecompt operation in eleven patients presenting with transposition of the great vessels, ventricular septal defects, and pulmonary artery stenosis. The above procedure had been performed during the period 1995-1998, with the short-term and remote results having been analyzed. A detailed description is given of the surgical technique. The Lecompt procedure was found to be superior to the Rastelli operation.
Subject(s)
Transposition of Great Vessels/surgery , Cardiac Surgical Procedures/methods , Child , Child, Preschool , Heart Septal Defects, Ventricular/surgery , Humans , InfantABSTRACT
During the 1991-1998 yrs period there were operated on 20 patients with coarctation of aorta (CoA), aged up to 1 year old, in whom the ejaculatory fraction (EF) of left ventriculus (LI) was not exceeding 40%. All the patients were admitted to the hospital in the severe state of health, the end-diastolic (EDI) and the end-systolic (ESI) index constituting accordingly (144.2 +/- 47.2) and (84.2 +/- 34.7) ml/m2, EF LV--(34.2 +/- 4.7)%. After the operation one patient have died, the mortality was 5%. In three to eight days after the operation EDV have lowered by 15% on average, EF LV--have enhanced by 20%. In the majority of children in the late follow-up period EDI and ESI have lowered significantly, approximating the normal level, EF LV have normalized. The significant lowering of the LV function and the extremely severe state of the patient with CoA are not contraindications to the surgical intervention performance, vice versa, to such the patients the intensive therapy and the urgent operation conduction are indicated. The CoA demolition not only saves the child's life but fully normalizes the LV function in majority of the patients.
Subject(s)
Aortic Coarctation/surgery , Myocardial Contraction , Ventricular Dysfunction, Left/surgery , Anastomosis, Surgical , Aorta/surgery , Aortic Coarctation/physiopathology , Humans , Infant , Infant, Newborn , Ventricular Dysfunction, Left/physiopathologyABSTRACT
The experience of myocardium protection during performance of operation of arterial switching (AS) in 57 patients was analyzed. In 30 patients cardioplegic solution was infused at one moment, what had advantages in comparison with its multimoment infusion.
Subject(s)
Cardiac Surgical Procedures/methods , Heart Arrest, Induced/methods , Monitoring, Intraoperative , Myocardial Ischemia/prevention & control , Humans , Infant , Infant, Newborn , Retrospective StudiesABSTRACT
Two-directional cava-pulmonary anastomosis was done in 35 patients with a inborn heart failure, ageing from 10 months to 11 years. In 29 patients the significant improvement of their state was noted. The level of arterial blood saturation with an oxygen have rised up to (90.1 +/- 2)% at average. Of 7 patients with the syndrome of right ventriculus hypoplasia one have died, of 27 patients with the single venticular heart-3.
Subject(s)
Ductus Arteriosus, Patent/surgery , Pulmonary Artery/surgery , Superior Vena Cava Syndrome/congenital , Superior Vena Cava Syndrome/surgery , Anastomosis, Surgical/methods , Child , Child, Preschool , Humans , InfantABSTRACT
The authors analyze their experience gained in the treatment of newborns and infants aged under one with complete transposition of the main vessels; arterial change-over method was employed. Five infants with complete transposition of the main vessels aged 14 to 70 days (27.6 days on an average) weighing 3.2 to 3.9 kg (3.7 kg, on an average) was operated on from January to June, 1992. All the patients presented with D-type complete transposition of the main vessels; interventricular septum was intact in four and defective in one patient. All the operations were performed under conditions of cardiopulmonary bypass with deep hypothermia (17 degrees C). Complete circulation arrest was employed in all the cases. Two of the five patients died, this making hospital mortality 40%. Death was caused by acute cardiac failure which developed in the postperfusion period and was fatal.
