ADVANCED INTEGRATED APPROACH TO SURGICAL TREATMENT Of PULMONARY ARTERIAL HYPERTENSION ASSOCIATED WITH CONGENITAL HEART DISEASE
https://doi.org/10.17802/2306-1278-2016-4-25-32
Abstract
Pulmonary arterial hypertension (PAH) is a common complication of congenital heart disease (CHD) occurring in left-to-right shunt. The progression of PAH is associated with delayed diagnosis and surgical treatment of congenital heart disease. An uncorrected left-to-right shunt in patients with CHD lead to histological changes of pulmonary vessels and reversal of the shunt may arise, with the development of Eisenmenger’s syndrome. Until recently, the surgical treatment of patients thought to be impossible, and few attempts to perform radical correction were associated with high in-hospital mortality. The main causes of the in-hospital mortality included acute right ventricular failure, pulmonary hypertension crisis and cardiac arrhythmias. The long-term survival of these patients was low, directly associated with the progression of residual pulmonary hypertension. The novel technique of a fenestrated double patch has been widely used abroad, but very rarely in Russia. Moreover, there is no standardized algorithm for selecting surgical approach in these patients as well as common approaches to the preoperative management and anesthetic protocol. The efficiency of specific therapies for residual pulmonary hypertension is poorly understood. Lack of research and experience in applying the fenestrated double patch in Russia for a population of children and adolescents who require combined treatment (surgical and specific therapy for pulmonary arterial hypertension) proved our research to be pivotal.
About the Authors
A. V. NOKHRIN
Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases. Kemerovo, Russia
Russian Federation
Russian Federation
Address: 6, Sosnoviy blvd., Kemerovo, 650002, Russian Federation Tel.: +7 (3842) 64-05-69
A. V. KUZMIN
Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases. Kemerovo, Russia
Russian Federation
Russian Federation
M. V. KULAVSKAYA
Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases. Kemerovo, Russia
Russian Federation
Russian Federation
I. N. SIZOVA
Federal State Budgetary Scientific Institution Research Institute for Complex Issues of Cardiovascular Diseases. Kemerovo, Russia
Russian Federation
Russian Federation
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Review
For citations:
NOKHRIN A.V., KUZMIN A.V., KULAVSKAYA M.V., SIZOVA I.N. ADVANCED INTEGRATED APPROACH TO SURGICAL TREATMENT Of PULMONARY ARTERIAL HYPERTENSION ASSOCIATED WITH CONGENITAL HEART DISEASE. Complex Issues of Cardiovascular Diseases. 2016;(4):25-32. (In Russ.) https://doi.org/10.17802/2306-1278-2016-4-25-32
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