Tratamentul chirurgical al malformaţiilor cardiace asociate în transpoziţia corijată a vaselor magistrale

Abstract

From 1991 to 2006 under supervision there were 3535 patients with various CHD, among them 26 patients with CCTGA [0.7 %] in the age of from 4 till 48 years have been revealed. In this group of patients has met next pathology: insuffi ciency of the tricuspid [arterial] valve at 6 patients, VSD - 4, A-V block III at 5 (at 4 primarily, at 1 – after repairof VSD), insuffi ciency of mitral (venous) valve - 3 (at 1 from them as a result of bacterial endocarditis after implantation of endocardial electrode). Operations concerning accompanying anomalies, and also developed complications 11 patients have been made (34.5% from numbers of patients with CCTGA). At all 12 operations have been made: Correction of insuffi ciency of systemic valve at 6 patients (repair at 4, valve replacement - 2 patients), plasty of VSD - 4, implantation of pacemaker - 5, repair of mitral valve - 2. Operations are executed without lethal outcomes. Patients were observed in terms from 8 months till 9 years. Concerning progressing insuffi ciency of the tricuspid valve replacement was done at 1 patient in 2 years after primary operation and another one in 1 year after repair of tricuspid valve need reoperation for insuffi ciency of it. Medicamentous support concerning progressing heart insuffi ciency is received by 1 patient of 48 years. The submitted material confi rms the given literatures on high risk of development of complete A-V bloc, insuffi ciency of the tricuspid valve, and also probability of development of insuffi ciency of right ventricle in arterial position in 4-th decade of a life. Early revealing and adequate correction of accompanying defects and developing complications allow to keep a life the patient and to receive satisfactory immediate and long-term results.