Algoritmul chirurgical în tratamentul defectului septal ventricular, asociat cu defectul septal atrial

Аннотация

The goal of this study is the comparative assesment of different methods of surgical correction and contemporary points of view in cases of Ventricular Septal Defect (VSD) associated with Atrial Septal Defect (ASD). The frequency of this congenital disease is variable and established at 7-12% from the CHD. The association of VSD and ASD increases the gravity of the general condition of health and prognostic. 39 VSD associated with ASD patients (18 men and 21 women) took part at the study which were operated during 1995-2006 in the department of congenital heart diseases. The surgical interventions at the patients with VSD in association with ASD were made on bypass with an average duration of 47,3 ±3,1 minutes, the average aortic clamp time of 34,3 ± 2,5 minutes and the average period of mechanic ventilation of 10,9 ± 0.8 hours. The VSD plastia was made by direct suture at 34 (82,2 %) patients and with autolog pericardial patch at 5 (12,8 %) patients. In our patients lot occurred just 1(2,6%) decease during the operation, caused by acute cardio-respiratory insuffi ciency. The estimation of the average amount of the echocardiography indicators have shown favorable changes. The mitral, aortic, pulmonary and tricuspid insuffi ciency diminishes or disappears. By analyzing these results we have come with the algorithm of management for patients with VSD associated with ASD.