Malska A. A.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Results of surgical treatment and incidence of postoperative complications in the follow up period were analyzed using primary data and outpatient medical records of the children treated at Lviv Children’s Regional Hospital in the period of September 1999 – January 2016. Majority of the patients with Down syndrome underwent a two-stage surgical correction: pulmonary artery banding at the age of 2-3 months, followed by radical surgery at an older age (2-3 years) (p <0.05), while patients without chromosomal pathology were performed one-stage surgical correction. It was found that the hemodynamic features in children with complete AVCD without Down syndrome determine significantly higher need for reoperation (20.00 ± 8.00% versus 0%; p = 0.038). Radical surgical intervention does not provide complete correction of mitral valve insufficiency – in the long-term postoperative period, 100 % of children had varying degrees of insufficiency on the mitral valve: in particular, in 10.91 ± 4.20 % of mild stage (2+) and in 3.64 ± 2.52% – severe (3+). At the same time, the tricuspid valve insufficiency remained in 47.27 ± 6.73 % of the operated children, and the interventricular septum re-shunt was determined in 5.45 ± 3.06 % of the children. The obtained results prove the need for long term follow-up of children with surgically-corrected AVSD in order to diagnose the degree of insufficiency of mitral and tricuspid valves and to refer for re-operation in time.

children, atrioventricular canal defect, Down syndrome, radical surgical correction, re-operation

1. Antonyuk OP, Hnateyko OZ, Prokopchuk NM, Helʹner NV. Suchasnyy stan pryrodzhenykh vad rozvytku lyudyny. Visnyk problem biolohiyi i medytsyny. 2016;2(3):12-9. [in Ukrainian].
2. American Heart Association Task Force on Practice Guidelines. ACC/AHA. Guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology. J. Am. Coll. Cardiolog. 2006;48:1-148.
3. Giannopoulos A, Gavras C, Sarioglou S, Agathagelou F, Kassapoglou I, Athanassiadou F. Atrial septal aneurysms in childhood: prevalence, classification, and concurrent abnormalities. Cardiol Young. 2014;24:453-8.
4. Shamrin UN, Pustovoitov AV, Teplov PV, Haliulina AR, Tokarev AB, Druzhinina SM, i dr. Otdalennyy rezul’tat radikal’noy korrektsii redkoy formy atrioventrikulyarnogo kanala. Sibirskoye meditsinskoye obozreniye. 2010;1(61). [in Russiаn].
5. Jonas R, DiNardo J. Comprehensive Surgical Management of Congenital Heart Disease. Arnold. 2004;525.
6. Calabro R, Limongelli G. Complete atrioventricular canal. Orphanet Journal of Rare Diseases [Internet]. 2006;1172:1-8. DOI: 10.1186/1750. Available from: http://www.OJRD.com/content/1/1/8
7. Cheng HL, Huang CH, Tsai HE, Chen MY, Fan SZ, Hsiao PN. Intraoperative assessment of partial atrioventricular septal defect with a cleft mitral valve by real-time three-dimensional transesophageal echocardiography. Anesth Analg. 2012;114:731-4.
8. Espinola-Zavaleta N, Muñoz-Castellanos L, Meave-Gonzalez A. Atrioventricular Septal Defects. Cardiac CT and MR for Adult Congenital Heart Disease. New York: Springer, 2013:347-60. DOI: 10.1007/978-1-4614-8875-0_14
9. Widya A, Vitriyaturrida, Anjarwani S. Clinical effect of ivabradine in patient with congestive heart failure with cardiogenic shock condition: A case report. European Heart Journal Supplements. 2016;18(B):B51-B57.
10. Dudnyk VM, Zborovsʹka OO. Osoblyvosti klinichnoho perebihu vrodzhenykh vad sertsya u ditey pislya operatyvnoyi korektsiyi zalezhno vid typu porushennya hemodynamiky. Visnyk Vinnytsʹkoho natsionalʹnoho medychnoho universytetu. 2015;19(1):30-3. [in Ukrainian].
11. Hoohenkerk GJ, Bruggemans EF, Rijlaarsdam M, Schoof PH, Koolbergen DR, Hazekamp MG. More than 30 years’ experience with surgical correction of atrioventricular septal defects. Ann Thorac Surg. 2010;90:1554-61.
12. Minich LL, Atz AM, Colan SD, Sleeper LA, Mital S, Jaggers J, et al. Partial and transitional atrioventricular septal defect outcomes. Ann Thorac Surg. 2010;89:530-6.
13. Kondratyuk MO, Gutor TG, Strilchuk LM, Zhakun IB, Sorokopud OO, Besh OM. Individual prognosis of complications in the presence of chronic heart failure. Likarsʹka Sprava. 2018;5-6:37-43. Available from: https://doi.org/10.31640/JVD.5-6.2018(5)

«Bulletin of problems biology and medicine» Issue 4 Part 2 (154), 2019 year, 135-138 pages, index UDK 616.12-008.318.1

10.29254/2077-4214-2019-4-2-154-135-138