[Pulmonary atresia with ventricular septal defect and major aorto-pulmonary collateral arteries: diagnosis and treatment].

The basic principles of diagnosis and management of pulmonary atresia with ventricular septal defect and major aorto-pulmonary collateral arteries are systematizes in this paper. The personal experience of surgical treatment of consecutive 66 patients with this disease is analyzed, including one-stage and multistage approaches.

[Antibodies to Hsp60 in newborn babies, to whom during the intervention for critical inborn heart failure, autologous cord blood was transfused, in early and late postoperative period].

The titre of antibodies to Hsp60 (heat shock protein) enhancement in the blood serum is considered a biological marker of poor state of organism. Comparative investigation was done on the antibodies titre to Hsp60 in the blood serum of a newborn babies, suffering critical inborn heart failure, to whom autologous cord blood or the donor's blood components was transfused, in early and remote postoperative period. In early postoperative period the lowering of the antibodies titre to Hsp60 in the blood serum was observed in comparison with them preoperatively, in a late period (in 2 yrs) in all the blood serum samples investigated antibodies to Hsp60 were not revealed. In 35% of patients, to whom the donor's blood components were transfused, there was registered the enhancement of the antibodies to Hsp60 titre in early postoperative period. High titre of antibodies have associated with enhanced rate of complications. In late postoperative period antibodies to Hsp60 were revealed in 20% of the examined patients.

[The influence of autologous umbilical cord blood and donor blood on cytokine profile of newborns with transposition of great vessels].

We investigated the serum levels ofproinflammatory and antiinflammatory cytokines (TNF-alpha, IL-1beta, IL-6, IL-8, IL-10) in newborns with transposition of the great arteries to whom during the defect correction the autologous umbilical cord blood and blood components were administered before the surgery and at the 1st, 3rd, 7th day after the surgery. We found that in the group of newborns to whom during the operation the blood components were used, the levels ofpro-inflammatory interleukins were high before surgery and at the Ist, 3rd and 7th day after it, but IL-10 was reduced. During the postoperative period, the newborns of this group had imbalance in the system cytokine, accompanied by clinical complications such as hyperthermia and pulmonary complications. Newborns with transposition of the great arteries who had the surgery using the autologous cord blood, had no significant abnormalities in serum levels cytokine before the surgery. The Ist day after surgery there was an increase in both proinflammatory and antiinflammatory cytokines. Up to 7 days the levels of interleukin gradually decreased. Newborns in this group had no postoperative complications, had an adequate immune response to the operation.

[Arterial switching operation in the first hours of life of newborn babies with transposition of the main vessels diagnosed prenatally].

A global tendency of enhancement of a prenatal diagnosis establishment rate in critical inborn heart failures demands to overestimate the existing surgical strategy. Taking into account a present sufficient compensation of a newborn babies state, suffering main vessels transposition, in first hours of the patients life and existing possibility to approve a surgical tactics before the patient's birth after the prenatal diagnosis establishment, we have proposed an innovative approach, consisting of conduction of the arterial switching operation without preliminary performance of the balloon atrioseptostomy and preoperative medicinal therapy. The efficacy and security of a new approach were analyzed.

[Surgical correction of total abnormal drainage of pulmonary veins: analysis of existing procedures].

The total failing drainage of pulmonary veins (TFDPV) is characterized by absence of connection between pulmonary veins and left atrium in coincidence with preservation of embryogenic connections between the pulmonary and caval veins systems. TFDPV constitutes 1-3% of the total of the inborn heart failures. The results of TFDPV surgical correction in 80 patients in 2000-2007 yrs are presented. The comparison of the treatment results, using different variants of operative interventions for TFDPV, was performed. The optimized protocols for diagnosis and treatment were proposed as well as own improved surgical procedure for TFDPV correction.