MODIFIED HYBRID METHOD FOR TREATING HYPOPLASTIC LEFT HEART SYNDROME IN NEONATES
Abstract
A «modified» hybrid method for treating hypoplastic left heart syndrome (HLHS) has been started in the Republican Scientific andPractical Center for Pediatric Surgery to stabilize neonates with «high risk». This method consists of bilateral pulmonary artery banding (BPAB) with continuous intravenous infusion of prostaglandin E1 to patent ductus arteriosus (PDA) until Norwood operation. Objective of the study was to evaluate the results of BPAB in «high-risk» neonates with HLHS. Material and methods. BPAB was performed in 155 «high-risk» children with HLHS in the Republican Scientific and Practical Center for Pediatric Surgery from January 2014 to February 2018. Operative age of the patients was 5.0 (3.0–11.8) days, weight – 2.9 (2.3–3.5) kg. After BPAB all children underwent continuous intravenous infusion of prostaglandin E1 to PDA until Norwood operation. Results. After BPAB 1 patient (6.7%) died in the early postoperative period (up to 7 days). Endovascular stenting of the PDA after BBLA was performed in 2 children (13.3%). 1 patient (6.7%) died in 6 months after BBLA. Norwood operation was performed in 13 children (86.7%) in 35.0 (27.0–57.0) days after BBLA. Pulmonary artery augmentation after debanding was needed in 1 patient (6.7%). Early postoperative mortality (up to 7 days) after Norwood operation was 20.0%, 30-days mortality – 26.7%. Conclusion. BPAB with continuous intravenous infusion of prostaglandin E1 may be successfully used in «high-risk» neonates with HLHS to improve the results of surgical treatment.
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References
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Copyright (c) 2018 Е. В. Королькова, А. В. Горустович, Ю. И. Линник, А. К. Барсумян, В. В. Дроздовская, К. В. Дроздовский
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