RESUMO
Experience of surgical correction of failures, concomitant with corrected transposition of main vessels (CTMV) in 29 patients was summarized. For pulmonary artery (PA) stenosis demolition in 10 patients the conduits of various design were applied, for moderate left atrioventricular valve (LAVV) insufficiency--its prosthetics. Surgical treatment mortality was 20.7%. Late follow-up results of the operation was studied up in 16 (66.7%) patients. Mean period of observation constituted 3.3 years. Good result was noted in 7 patients, fair--in 9. Lowering of contractile ability of "arterial" ventriculus and the LAVV insufficiency progress were the causes of follow-up results changing for worse. Application of conventional methods of treatment do not put away the basic disorder--CTMV.
Assuntos
Transposição dos Grandes Vasos/cirurgia , Adolescente , Adulto , Angiografia , Criança , Pré-Escolar , Seguimentos , Humanos , Lactente , Transposição dos Grandes Vasos/diagnóstico por imagemRESUMO
From 1963 to 1985, 232 operations were carried out for constriction of the pulmonary artery in ventricular septal defect (VSD) with high pulmonary hypertension with 6% mortality. 74 patients were examined after a palliative operation. According to the results of catheterization of the heart cavities, the effect of the first stage of surgical correction of the defect was good in 55, satisfactory in 8, and poor in 11 patients. Radical operation for closure of VSD and debanding of the pulmonary artery were performed in 52 patients with 19.2% hospital mortality. During follow-up of the late-term results of two-stage correction of the defect catheterization of the heart cavities with angiocardiography was conducted in 13 patients, pressure in the pulmonary artery in 12 of them was normal (26.4 +/- 1.8%). Prevention of hemorrhage during freeing of the heart from adhesions as well as sparing techniques of VSD closure may reduce mortality in repeated surgical intervention essentially.
