Abstract: At 246 patients with coarctation of the aorta the ultrasonic semiotics of disease has been investigated. Are systematized echocardiographycal attributes of defect: are determined direct and indirect (displays directly reflecting morphology), the estimation of their sensitivity and specificity is lead. The certain combination of the specified attributes has allowed to allocate three variants of a ultrasonic picture coarctation of the Aorta, reflecting various anatomic forms of defect. The semiotics and diagnostic attributes of each ultrasonic variant of defect is described by echocardiography. Reference 1. Шиллер Н., Осипов М. А. Клиническая эхокардиография. М. 1993. 2. Митьков В. В., Сандриков В. А. Клиническое руководство по ультразвуковой диагностике в 5 т. М.: Видар. 1998; 5: 96-297. 3. Бураковский В. И., Бокерия Л. А. Сердечно-сосудистая хирургия (руководство). М.: Медицина.1989; 298-310. 4. Kaine S. E, Smith E. О., Mott A. R. et al. Quantitative echocardiographic analysis of the aortic arch predicts outcome of balloon angioplasty of native coarctation of the aorta. Circulation. 1996; 94 (5): 1056-1062. 5. Фейгенбаум X. Ультразвуковая диагностика. М.: Медицина. 1999; 1123-1145.
Abstract: Stenting of the patent ductus arteriosus (PDA) is a relatively new method of palliative treatment ir children with congenital heart disease (CHD) and is an alternative to systemic-pulmonary shunt. Aim: was to evaluate the efficacy of stenting in the PDA as a palliative care in children with pulmonary ductus-dependent hemodynamic in «Children Repubfcan Clinical Hospital» (CRCH). Materials and methods: we analyzed data of 11 patients, with CHD and pulmonary ductus-dependent hemodynamics, who underwent stenting of PDA in CRCH for the period of 2007-2015. To assess the effectiveness of the procedure we took into consideration following data: clinical diagnosis; patient's condition before and after stenting of PDA. Results: primary stenting of PDA was success in 10 patients, there was no severe complication and death. In 1 patient, there was a stent migration to the pulmonary artery, and due to the closure of the PDA and thus increasing cardiovascular insufficiency, child was taken to the corrective surgery, during which the stent was removed. As a result, in 10 successfully stented patients, in nearest follow-up observation period (15 to 28 days, mean 22 days), 7(70%) patients had a positive effect; in 3 patients progressing hypotension appeared on the 2nd day after the treatment, that leaded to pefrorming of endovascular procedures with Rashkind's method. In the later follow-up observation period, 6 of 7 patients had remaining satisfactory parameters of pulmonary hemodynamics (saturation ranged from 78% to 92%), before using of radical correction of pathology (in terms of 3 to 6 months.). Conclusion: the stenting procedure for closing of PDA as a palliative treatment for infants with CHD and pulmonary ductus-dependent hemodynamics is effective to stabilize the severe clinical condition of patients prior to radical correction of defects in 60% of cases. References 1. Denise van der Linde, Elisabeth E.M. Konings, Maarten A. Slager, at al. Prevalence of Congenital Heart Disease Worldwide : A Systematic Review and Meta-Analysis. Journal of the American College of Cardiology. 2011; 58(21): 2241-2247. 2. Emelyanchik E.Y., Kirilova Y.P., Yakshanova S.V., et al. Rezultaty primeneniya preparata prostoglandina E1 Vazaprostana v lechenii detey s duktus-zavisimym krovoobrascheniem. [Results of drug prostaglandin E1 Vazaprostan in treatment of children with ductus-dependent hemodynamics]. Sibirskoe meditsinskoe obozrenie. 2013; 6: 68-72. [In Russ]. 3. Mirolubov L.M. Vrozhdyennye poroki serdtsa u novorojdennykh I detey pervogo goda zhizni. [Congenital heart defects in newborns and infants]. Kazan. 2008: 33-51. [In Russ] 4. Vakhvalova I.V., Idov Е.М., Shirogorova A.V.,et al. Duktus- zavisimye vrozhdennye poroki razvitiya serdtsa u detey: osobennosti klinicheskogo techeniya na etapakh do- i posleoperatsionnogo vykhazhivaniya. [Ductus-dependent congenital heart disease in children: clinical features at stages of pre- and postoperative nursing.] Vestnik uralskoy meditsynskoy akademicheskoy nauki. 2008; 2: 47-52. [In Russ] 5. Bokeriya L.A., Alekyan B.G. Rukovodstvo po rentgenendovaskulyarnoy hirurgii serdtsa I sosudov. [Guidelines for endovascular surgery of the heart and blood vessels. The 3 volumes.] Т 2. Moskow. 2013; 289-303. [In Russ]. 6. Berishvili I.I., Garibyan V.A., Aleksii-Meskhishvili V.V., et al. Priobretyennaya deformastiya legochnoy arterii posle nalozheniya mezharterialnogo anastomoza u detey rannego vozrasta. [Acquired deformity of the pulmonary artery anastomosis after the imposition between arterial in infants]. Grudnaya khirurgiya. 1978; 5: 51-56. [In Russ]
Tactics and results of combined treatment (surgical and endovascular) of neonates with congenital heart disease
DOI: https://doi.org/10.25512/DIR.2011.05.4.11
For quoting:
Kislukhin T.V., Avramenko A.A., Gorjachev V.V., Kozeva I.G., Shorokhov S.E., Lapshina N.V., Khokhlunov S.M. "Tactics and results of combined treatment (surgical and endovascular) of neonates with congenital heart disease". Journal Diagnostic & interventional radiology. 2011; 5(4); 63-70.
Abstract: Palliative surgery plays a major role as a stage of congenitalheart disease treatment.Palliative endovascular interventions are safe n neonates. Such treatment can stabilize patients and adequately prepare them for radical operation and in some cases it is an alternative to classic bypass methodic. References 1. Бокерия Л.А., Гудкова Р.Г. «Сердечно-сосудистая хирургия-2009». Врожденные пороки системы кровообращения. М.: изд-во НЦССХ им. А.Н. Бакулева РАМН. 2010; 76-115. 2. Rosano A. et al. Infant mortality and congenital anomalies from 1950 to 1994. An international perspective. J. Epidemiol. Community Health. 2000; 54: 660-666. 3. Шарыкин А.С. Врожденные пороки сердца. Руководство для педиатров, кардиологов, неонатологов. М.: изд-во «Теремок». 2005; 8-14, 224-234. 4. Любомудров В.Г., Кунгурцев В.Л., Болсуновский В.А. и др. Коррекция врожденных пороков сердца в периоде новорожденности. Российский вестник перинатологии и педиатрии. 2007; 3: 9-13. 5. Lacour-Gayet F., Anderson R.H. A uniform surgical technique for transfer of both simple and complex patterns of the coronary arteries during the arterial switch procedure. Cardiol. in the Young. 2005; 15 (1): 93-101. 6. Gibbs J.I. Treatment options for coarctation of aorta. Heart. 2000; 84: 11-13. 7. Zales V.R., Muster A.J. Ballon dilatation angioplasty for the management of aortic coarctation. In C. Mavroudis, C.L. Backer et al. Coarctation and interrupted aortic arch. Cardiac surgery. State of art review. Philadelphia. Huley & Belfus. 1993; 7: 133. 8. Chen Q., Parry A.J. The current role of hybrid procedures in the stage 1 palliation of patient with hypoplastic left heart syndrome. Eur. J.Cardiolthorac. Surg. 2009; 36: 77-83. 9. Michel-Behnke I. et al. Stent implantation in the ductus arteriosus for pulmonary blood supply in congenital heart disease. Catheter. Cardiovasc. Interv. 2004; 61 (2): 242-252. 10. 10. Bisoi A.K. et al. Primary arterial switch operation in children presenting late with d-transposition of great arteriaes and intact ventricular septum. When is it too late for a primary arterial switch operation? Eur. J. Cardiothorac. Surg. 2010; 38: 707-713.
Abstract: A case report of right ventricular outlet (RVO) stenting as palliative treatment of pulmonary artery atresia (PAA) in combination with interventricular septum defect (ISD), in situation when radical surgical intervention has high operative risk due to condition severity and low weight RVO stenting in newborn and children with low weight is made seldom and noted as a case reports. Peculiarity of this case is that intervention was made in patient with extremely low weight and age (age - 6 month, weight - 3 kg) after performed early central aorto-venous bypass and further palliative reconstruction of right ventricular outflow. References 1. Chang A.C., Hanley F.L., Lock J.E., et. al. Management and outcome of low birth weight neonates with congenital heart disease. J. Pediatr. 1994; 124: 461-6. 2. Reddy V.M., Elhinney D.B., Sagrado T., et.al. Results of 102 cases of complete repair of congenital heart defects in patients weighing 700 to 2500 grams. Thorac. Cardiovasc. Surg. 1999; 117: 324-31. 3. Wernovsky G., RubensteinS.D., Spray T.L. Cardiac surgery in the low-birth weight neonate: new approaches. Clin. Perinatol. 2001; 28:249-4. 4. Laudito А., Varsha M., Bandisode J., Lucas F. et al. Right Ventricular Outflow Tract Stent as a Bridge to Surgery in a Premature Infant with Tetralogy of Fallot. Ann. Thorac. Surg. 2006; 81:744-746. 5. Kirklin J. V., Barrat-Boyes. Cardiac surgery J V. New York: Churhill Livingstoun 2003. 6. Sahu Raj., Syamasundar Rao., Transcatheter Stent Therapy in Children: An Update. Pediat. Therapeut. 2012, S5. 7. Meadows J., Catheter-Based Interventions for Congenital Heart Disease Meadows Jeff. J. Clin. Exp. Cardiolog. 2012, S: 8. 8. Gibbs J.L., Uzun O., BlackburnM.E., et. al. Right ventricular outflow stent implantation: an alternative to palliative surgical relief of infundibular pulmonary stenosis. Heart. 1997; 77:176-9. 9. Sugiyama H., Williams W., Benson L.N. Implantation of endovascular stents for the obstructive right ventricular outflow tract Heart. 2005; 91:10581063.doi:10.1136/ hrt.2004.034819. 10. Alwi M., Alwi M., Choo K.K., Latiff H.A., et. al. Initial results and medium-term follow-up of stent implantation in patent ductus arteriosus in ductdependent pulmonary circulation. J. Am. Coll. Cardiology 2004; 44(2):438-45. 11. Gladman G., Mc Crindle B.W., Williams W.G., et. al. The modified blalock-taussig shunt: clinical impact and morbidity in Fallot’s tetralogy in the currentera. J. Thorac. Cardiovasc. Surg. 1997; 114:25-30.
Abstract: Despite the fact that so far in the literature, many cases of endovascular closure of paravalvular leak (PVL), this type of intervention is unusual and is associated with a complex technical issues. In addition, the majority of publications devoted to the correction of mitral and aortic PVL, while the description of the closing of the tricuspid valve (TV) PVL are rare. Below is a description of our first experience of endovascular correction of TV PVL in 54 years ole patient, who underwent TV repair with «Neokor-32» - supporting ring as a correction of atrial septal defect, TV insufficiency One year after surgery the patient reported a decrease in physical activity tolerance. Echocardiography diagnosed hemodynamically significant PVL of TV, 6mm size with leakage between the left ventricle and the right atrium and formation of pulmonary hypertension. PVL was successfully treated by endovascular correction with using of device for closure of ventricular septal defect. References 1. Galea A. et al. Practical applications of digital tomosynthesis of the chest. Clinical radiology. 2014; 69(4): 424-430. 2. de Koste J. R. S. et al. Digital tomosynthesis (DTS) for verification of target position in early stage lung cancer patients. Medical physics. 2013; 40(9): 091904. 3. Dobbins III J. T. et al. Digital tomosynthesis of the chest for lung nodule detection: interim sensitivity results from an ongoing NIH-sponsored trial. Medical physics. 2008; 35(6): 2554-2557. 4. Vikgren J. et al. Comparison of Chest Tomosynthesis and Chest Radiography for Detection of Pulmonary Nodules: Human Observer Study of Clinical Cases 1. Radiology. 2008; 249(3): 1034-1041. 5. Quaia E. et al. Digital tomosynthesis as a problemsolving imaging technique to confirm or exclude potential thoracic lesions based on chest X-ray radiography. Academic radiology. 2013; 20(5): 546-553. 6. Jung H. N. et al. Digital tomosynthesis of the chest: utility for detection of lung metastasis in patients with colorectal cancer. Clinical radiology. 2012; 67(3): 232-238. 7. Nikitin M. M. Possibilities of digital tomosynthesis in the diagnosis of various forms of pulmonary tuberculosis. REJR. 2016; 6 (1): 35-47. [In Russ]. 8. F.Kovach F., Zhebek Z. X-ray anatomical basics of lungs’ examinations. Budapest, 1958; 364 p. [In Russ]. 9. Trofimova T. N. ed. Human X-ray anatomy. SPb.: Publishing house SPbMAPO. 2005; 496 p. [In Russ]. 10. Sapin M. R. ed. Human Anatomy. Moscow, M.: Medicine. 2001; 640 p. [In Russ]. 11. Sinelnikov R. D., Sinelnikov Ya. R. Atlas of human anatomy. M.: Medicine. 1996; 344 p. [In Russ]. 12. Kokov L. S., ed. X-ray Atlas of comparative anatomy. M.: Radiology-Press., 2012; 388 p. [In Russ].
