Abstract
Introduction. The problem of lost connection between venous ventricle and the pulmonary arteries remains relevant in the surgery of congenital heart disease. Relevance is caused by till now absent full extent of physiological way of correction. Pulmonary allograft having a locking element created by nature during long evolution process and it best meets physiologic requirements. The purpose of the research is to develop techniques of implantation of pulmonary allograft and to evaluate the early results of the children's venous ventricular outflow tract reconstruction.
Materials and methods. 28 cases of pulmonary allograft implantation carried out on children from February 1994 to April 2015. The median of age for the moment of operation is 52 months (min 18, max 72), body weight 15 kg (min 9,4; max 20). All children suffered from congenital heart defects. 26 patients had redo surgery. The cryopreserved devitalized allografts made by the laboratory of A.N. Bakoulev National Medical Research Center for Cardiovascular Surgery were implanted in most patients.
Results. In 13 patients allograft was used as an artificial pulmonary artery trunk; in 15 – orthotopic implantation. The median venous ventricle systolic pressure was 34 mm Hg. One (3.5%) child died. The death was caused by the recurrent pulmonary bleedings. The other children were successfully discharged from the department. The peak pressure gradient between the venous ventricle and the pulmonary arteries was 19 mm Hg (min 4, max 34). Pulmonary valve insufficiency was absent at 13 patients, at 14 did not exceed 1,5 degrees.
Conclusion. Pulmonary allograft is an effective option of the venous ventricular outflow tract reconstruction, providing a good early result.
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About the authors
- Zelenikin Mikhail Anatol'evich, Dr. Med. Sc., Professor, Chief Researcher; orcid.org/0000-0002-9350-8641
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Volkov Sergey Sergeevich, Cand. Med. Sc., Senior Researcher; orcid.org/0000-0003-2005-4957
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Narmaniya Ivan Tengizovich, Postgraduate; orcid.org/0000-0003-0936-6116
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Britikov Dmitriy Vyacheslavovich, Dr. Med. Sc., Chief of Laboratory
