Abstract
Staged univentricular repair (bidirectional cavopulmonary anastomosis (BCPA) and subsequent Fontan operation) is the main technique for repair of malformations with univentricular hemodynamics. The key to the success of this approach is the observance of the appropriate criteria for the patients selection. BCPA as first stage can be done in most cases. But the Fontan operation is not possible in some cases due to the complex nature of the defects or comorbidity. In these situations BCPA appears the «definitive» palliative procedure. With time and the growth of the child there is a progressive decrease in the contribution of BCPA to the pulmonary circulation which results in a decrease in arterial oxygen saturation, degradation of exercise tolerance and quality of life. In 1972 an axillary arteriovenous anastomosis was proposed for this patients. This report presents the first Russian experience of the Fontan operation after axillary arteriovenous anastomosis in small children with univentricular heart defects and univentricular repair risk factors identified previously, discusses the indications, contraindications, technical and tactical issues based on world and own experience.
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About the authors
- Dmitriy K. Gushchin, Cand. Med. Sci., Cardiovascular Surgeon, Senior Researcher; ORCID
- Leysan R. Khabibullina, Radiologist, Graduate Student; ORCID
- Svetlana A. Aleksandrova, Cand. Med. Sci., Radiologist, Chief of the Department of Magnetic Resonance Imaging; ORCID
- Sergey S. Volkov, Cand. Med. Sci., Cardiovascular Surgeon, Senior Researcher; ORCID
- Mikhail M. Zelenikin, Dr. Med. Sci., Professor, Cardiovascular Surgeon, Head of Department; ORCID
