Abstract
Introduction. The life of patients in a number of congenital heart defects (CHD) depends on the functioning of the patent ductus arteriosus (PDA). After birth, the priority is maintaining the operation flow to perform further surgical intervention. The most promising in terms of rapid elimination of hypoxemia and stabilization of clinical condition, is stenting of patent ductus arteriosus.
Material and methods. Stenting of the duct is made of 66 patients. Depending on the duration of stenting, the patients were divided into two groups: those with the irradiation time up to 40 (group I) and 40 min (group II). Patients were defined anatomic-morphological parameters of PDA can affect the duration of the surgical intervention: ductile-aortic angle, the confluence point, the diameter and length of the duct, a constriction and tortuosity, and the presence of stenosis of the pulmonary artery in the region of the confluence of the PDA. The age of patients ranged from 1 day to 12 months, weight – average 3441.4 ± 1441.8 g. Saturation of arterial blood with oxygen ranged from 24 to 66%. In 44 (66%) patients had acidosis with a blood pH of 7.12–7.32 BE from –3.4 to –16.2.
Results. In group I, stenting was successful in 31 (96.8%) patients. The Х-ray irradiation time average of 29.3 ± 9.3 min. In the postoperative period died 2 (6.4%) patients. In group II successful implantation was 24 (70%) patients. The Х-ray irradiation time – mean 66.2 ± 27.3 min. Overall mortality was 29.4% (10 patients). Non-fatal complications in 2 patients.
Conclusion. The effectiveness of stenting depends on the level of the discharge duct and duct-aortic angle, and the length and severe tortuosity of the duct.
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About the authors
- Бокерия Лео Антонович, академик РАМН и РАН, президент Центра, ORCID
- Алекян Баграт Гегамович, академик РАН, заместитель директора по науке и инновационным технологиям, ORCID
- Пурсанов Манолис Георгиевич, доктор мед. наук, врач – рентгенэндоваскулярный хирург, ORCID
- Ким Алексей Иванович, доктор мед. наук, заведующий отделением реконструктивной хирургии новорожденных и детей первого года жизни с ВПС, ORCID
- Петросян Карен Валерьевич, доктор мед. наук, заведующий отделением рентгенохирургических методов исследования и лечения сердца и сосудов, ORCID
- Нефедова Инесса Евгеньевна, канд. мед. наук, заведующая отделением экстренной хирургии недоношенных и детей первого года жизни, ORCID
- Свободов Андрей Андреевич, доктор мед. наук, врач – сердечно-сосудистый хирург, ORCID
- Григорьян Ашот Михайлович, канд. мед. наук, заведующий отделением рентгенхирургических методов диагностики и лечения, ORCID
- Рахматов Бузургмехр Мирзоалиевич, заведующий отделением интервенционной кардиологии
