[Surgical treatment of aortic arch malformations in infants under cardiopulmonary bypass].

AIM: To evaluate long-term results and the causes of complications in congenital obstructive pathology of the aortic arch. MATERIAL AND METHODS: Retrospective study enrolled 62 patients aged 55 ± 14 days who underwent aortic arch surgery under cardiopulmonary bypass. It was compared two methods of aortic archplasty: use of xenopericardial material in group 1 and Rajasinghe's autoplastic method in group 2. RESULTS: Follow-up was 42 ± 14 months. In the long-term recoarctation occurred in 7 (13.7%) cases including 6 (18.75%) patients in group 1 and one (3.3%) patient in group 2. Residual hypertension was observed in 12 (23.5%) cases including 10 (37%) patients in group 1 and 2 (8.3%) patients in group 2. Six (50%) patients receive antihypertensive therapy, 5 (41.6%) patients who receive antihypertensive drugs have persistent increase of blood pressure without evidence of anatomic aortic obstruction. Hypertensive response to functional tests was observed in one patient. CONCLUSIONS: Aortic arch reconstruction using autoplasty is associated with lower risk of recoarctationand residual hypertension compared with xenopericardial patch application.

[Results of surgical treatment of the anomalous origin of the left coronary artery from the pulmonary trunk].

The experience of the federal medical center of the surgical treatment of small patients with the anomalous origin of the left coronary artery from the pulmonary trunk was analyzed. The early surgical treatment, directed at the reconstruction of the two sources of myocardial blood supply together with the standard use of "calcium sensitizer" ("Levosimendan") decrease the lethality to 6.6% without the use of extracorporeal membrane oxygenation. The restoration of the ischemized left ventricle after the correction and improvement of the concomitant mitral valve insufficiency were dynamically assessed in early postoperative terms.