Клінічна хірургія (Dec 2020)
The aortal arch plasty in a new-born babies, using “end-to-side” anastomosis
Abstract
Objective. To analyze the immediate and late follow-up results of the aortal arch plasty, using anastomosis «end to side». Materials and methods. In 2010 - 2019 yrs period in Amosov National Institute of Cardio-Vascular Surgery and Scientific-Practical Medical Centre of Pediatric Cardiology and Cardiosurgery in 75 new-born babies, suffering coarctation and hypoplasia of one or several segments of aortal arch its reconstruction was done, using ‘end-to-side” anastomosis. Into the investigation only the patients with a two-ventricular physiology and further two-ventricular correction were included. There were 41 (54.6%) boys and 34 (45.4%) girls. Average age of the patients was (2,5 ± 1,2) mo, and average body mass - (3.3 ± 0.6) kg. The main diagnostic method for the failure determination and immediate and late results studying was echocardiographic investigation. Results. Hospital lethality have constituted 6.6% (5 patients died). The lethality causes were not connected with the aortal arch reconstructive procedure, using anastomosis «end to side». Duration of follow-up was 1 mo - 9.3 yrs, (2.8 ± 2.5) yrs at average. In late follow-up period 1 patient died. In 11 (14.6%) patients in postoperative period the aortal arch restenosis have developed. In 7 patients restenosis was eliminated endovascularly, using balloon dilatation. In 4 patients the aortal arch surgical replasty was done. Tracheal and the main bronchi compression, neurological complications in late follow-up period were not observed. Conclusion. After plasty for the aortal arch hypoplasia, using anastomosis «end to side» in new-born babies good immediate and late follow-up results were noted, what witnesses its efficacy. In accordance to results of the investigation accomplished such kind of anastomosis applied may be used in patients, suffering hypoplasia of proximal aorta or in tubular hypoplasia of all aortal arch.
Keywords
