Reconstruction of aortal arch in patients with transposition of the main arteries: results of a one-stage correction
| Autor: | V. V. Lazoryshynets, O. Golovenko, I. V. Dzyurii, M. P. Radchenko, Ya. P. Truba |
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| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | Klinicheskaia khirurgiia. 87:41-45 |
| ISSN: | 2522-1396 0023-2130 |
| DOI: | 10.26779/2522-1396.2020.5-6.41 |
| Popis: | Objective. To analyze immediate and late results of a one-stage surgical treatment of the main arteries transposition in conjunction with obstruction on the level of aortal arch. Materials and metods. For the period 2010 - 2019 yrs in Amosov National Institute of Cardiovascular Surgery and Scientific-Practical Medical Centre of Pediatric Cardiology and Cardio-Surgery in 52 newborn babies a one-stage correction of the main arteries transposition with obstruction on the level of aortal arch was conducted. In the investigation were included only the patients with a two-ventricle physiology and further two-ventricle correction. There were 35 (67.3%) boys and 17 (32.7%) girls. Average age of the patients was (0.6 ± 0.3) mo, average body mass - (3.6 ± 0.8) kg. The main method of diagnosis in determination of the failure and estimation of immediate and late results was echocardiographic examination. In 24 (46.2%) of the patients while doing reconstruction of the aortal arch a selective antegrade cerebral perfusion was conducted. Results. Hospital mortality have constituted 3.8% (n=2). Duration of artificial blood circulation have constituted (194.3 ± 73.1) min, aortal clamping - (108.5 ± 35.6) min, selective cerebral perfusion - (19.6 ± 7.2) min. In early postoperative period 6 (11.5%) patients have been with desintegrated sternum. Average duration of observation have constituted (3.7 ± 2.8) yr (from 1 no to 9.yrs). In late period one child died. In 5 (9.6%) patients in postoperative period restenosis in aortal arch have developed, who was successfully curated endovascularly, using balloon dilatation in 3 patients, In two secondary plasty of aortal arch was done surgically. Tracheal or the main bronchi compression, neurologic complications were not observed in remote period. Conclusion. One-stage correction of the main arteries transposition together with the aortal arch hypoplasia - an effective and secure method of treatment of a newborn children with good immediate and late results. The investigation conducted gives a background to conclude, that this surgical strategy constitutes the affordable alternative to two-staged surgical treatment of this complex pathology. |
| Databáze: | OpenAIRE |
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