Dziuryi I. V., Truba Ia. P., Maistriuk H. V., Yakimishen O. O., Lazoryshynets V. V.

BIDIRECTIONAL CAVАPULMONARY ANASTOMOSIS AS A STAGE OF THE FONTAN HEMODYNAMIC STRATEGY (30 YEARS OF EXPERIENCE OF A SINGLE CENTER)

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Dziuryi I. V., Truba Ia. P., Maistriuk H. V., Yakimishen O. O., Lazoryshynets V. V.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

It has been established that approximately 13 per 1,000 newborns are diagnosed with congenital heart defects requiring surgical or interventional treatment as the child grows. Among children with congenital heart defects diagnosed at an early age, 7.7% present with anatomical features consistent with single-ventricle physiology. Stepwise formation of a total cavopulmonary connection represents one of the primary surgical approaches for the correction of complex congenital heart defects associated with single-ventricle physiology. The aim of this study was to evaluate perioperative characteristics in patients with congenital heart defects and single-ventricle physiology, as well as immediate and long-term outcomes following hemodynamic correction. Between 1996 and 2025, the Amosov National Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine performed palliative treatment in the form of a bidirectional cavopulmonary anastomo- sis as an intermediate stage of hemodynamic correction in 185 patients with functional single-ventricle physiology. The primary diagnostic modalities used to define the cardiac defect and to assess immediate and long-term outcomes were echocardiography and cardiac catheterization. Hospital mortality was 4.3% (n=8). Four deaths occurred in group I and four in group III, whereas no fatalities were observed in group II. An uncomplicated early postoperative course was noted in 77% of patients (n=142). The remaining 23% (n=43) experienced a total of 56 complications, distributed as follows: group I – 19 complications in 15 patients; group II – 14 complications in 13 patients; and group III – 23 complications in 14 patients. The contribution of superior vena cava flow depends directly on the patient's age and gradually decreases in older patients; therefore, the clinical effect of performing a bidirectional cavopulmonary anastomosis is significantly better when the operation is performed in early childhood (1 to 3 years).

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2025 Issue 4, 179, 129-140 pages, index UDC 616.12-007.2-053.2:616.12-089.843]-005.941

DOI:

10.29254/2077-4214-2025-4-179-129-140