Kalyta V. I., Dziuryi I. V., Boyko S. M., Truba Ia. P., Plyska O. I., Lazoryshynets V. V.

EXPERIENCE OF ANAESTHETIC MANAGEMENT AND INTENSIVE CARE IN PATIENTS WITH SINGLE VENTRICLE PHYSIOLOGY

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About the author:

Kalyta V. I., Dziuryi I. V., Boyko S. M., Truba Ia. P., Plyska O. I., Lazoryshynets V. V.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Single ventricle physiology is a term used to describe a group of complex congenital heart defects with a single functioning ventricle. The survival of such patients depends on mixing systemic deoxygenated blood with oxygenated pulmonary venous blood and on an open channel for redirecting the mixed blood to the small and systemic circulation. Palliative treatment of patients with single ventricle physiology aims to transfer the single ventricle circulation from parallel to sequential and includes three stages, culminating in total Fontan cavopulmonary anastomosis. Bidirectional cavopulmonary anastomosis is the second stage of haemodynamic correction in patients with single ventricle physiology. It eliminates parallel circulation and ventricular volume overload but not cyanosis. The study aims to describe the experience of anaesthetic management and intensive care in patients with single ventricle physiology at the stage of haemodynamic correction. From 1996 to 2022, 104 patients with a single ventricle underwent bidirectional cavopulmonary anastomosis at the Amosov National Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine. The main methods used to determine the defect and assess postoperative outcomes were cardiac cavity sounding and echocardiography. All patients were divided into two age groups. Group A included 57 patients (55%) aged 3 to 36 months, and Group B consisted of 47 patients (45%) over 36 months. There is a lower need for prolonged intensive care, a lower number and less severe severity of postoperative complications, a longer overall ICU stay, and a higher average systemic saturation in patients who were operated on between the ages of 3 and 36 months due to the peculiarities of haemodynamic and adaptive processes. The choice of age and tactics for hemodynamic correction in patients with single ventricle physiology directly affects the perioperative period and the results of palliative treatment.

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Publication of the article:

«Bulletin of problems biology and medicine», 2023 Issue 4, 171, 199-209 pages, index UDC 616.124-007.2-053.1-089:616-089.5

DOI:

10.29254/2077-4214-2023-4-171-199-209