Search

Background. There is quite a high number of patients with advanced heart failure (HF) who have undergone surgical treatment for complex congenital heart defects. Implantation of mechanical circulatory support systems is the only treatment option for patients with refractory end-stage heart failure. Only a few centers have experience in implantation of ventricular assist devices (VAD) in children, which is a major challenge for modern pediatric cardiac surgery. Objective: to present our first experience of implantation of HeartMate III VADs in patients after surgical correction of complex congenital heart defects. Materials and methods. From 2021 to 2022, at Bakulev Center for Cardiovascular Surgery, four HeartMate III systems were implanted in children with advanced HF, who had previously undergone surgery for a complex congenital heart defect. In one case, aortic valve implantation was carried out simultaneously with VAD implantation. Results. All patients were discharged from the center. One patient developed right-sided heart failure intraoperatively, which required the use of a right ventricular assist device (RVAD) for 8 days. There were no complications from the central nervous system, bleeding, pump thrombosis, or infection. Conclusion. HeartMate III can be implanted in patients with body weight ≥21 kg and BSA ≥0.88 m2 . Children’s tolerance to physical activity increases, they are fully adapted socially, and can attend school.

Background. Congenital malformations of the gastrointestinal (GI) tract are common birth defects detected in the neonatal period and usually present with signs of GI obstruction which at times can be life threatening. Anorectal malformations are among the more frequent congenital anomalies. The co-occurrence of congenital heart defect (CHD) along with GI malformation can significantly affect the natural history of either defect. Purpose - to study the prevalence of GI malformations in children with CHD and study the risk factors. Materials and methods. A total 100 patients of GI malformations were enrolled out of which 66 (66%) were males and 34 (34%) were females. All patients with any GI malformations (anorectal malformation, tracheoesophageal fistulae, anterior abdominal wall defects) presenting to Neonatal Intensive Care Unit (NICU), Paediatric Cardiac unit, Pediatric and Pediatric surgery outpatient department (OPD) as well as In-patient department (IPD) between October 2019 to October 2021 were included in study. A detailed history and examination was done followed by echocardiography and the prevalence of CHD among GI malformation was observed and risk factors were studied. Results. Most common GI anomaly was anorectal malformation (71%) followed by tracheoesophageal fistula (17%), CHD was seen in 14 children. Most common heart defect was ventricular septal defect (VSD) (43%) followed by patent ductus arteriosus (PDA) (36%) and atrial septal defect (ASD) (14%). Among cases with anorectal malformation, CHDs was seen in 10% and the most common defect was VSD (43%). Forty one percent of cases with tracheoesophageal fistula had CHDs with PDA (57%) being the most common underlying defect. Functional heart defects were present in 28 children of GI malformations. Conclusions. The coexistence and severity of CHD in patients with GI malformation can have prognostic implications. Thus, early cardiac evaluation should be performed in every case of GI malformation, preferably with echocardiography. This is likely to help in the risk stratification as well as management of such children. The study was performed in accordance with the principles of the Declaration of Helsinki. Study is approved by Ethical Committee of the Institution. Informed consent of patients was obtained for the study. No conflict of interests was declared by the authors.

Association of Cardiovascular Surgeons of Russia Russian Society of Cardiology (RSC)Association of Pediatric Cardiologists of RussiaRussian Scientific Society of Specialists in X-Ray Endovascular Diagnostics and TreatmentAll-Russian Public Organization for the Promotion of Radiation Diagnostics and Therapy "Russian Society of Radiologists and Radiologists".Task Force members declared no financial support/conflicts of interest. If conflicts of interest were reported, the member(s) of the working group was (were) excluded from the discussion of the sections related to the area of conflict of interest.

4—5 congenital heart defect cases per 1000 newborns are diagnosed worldwide. Some malformations require surgical methods of correction. Various risk factors contribute to the development of healthcare associated infections (HAIs). The HAIs are one of the leading causes of the prolongation of hospitalization length both in intensive care unit and in the inpatient departments, and they also play a significant role in increasing the number of lethal outcomes. A number of risk factors play an important role in the development of HAIs: the duration of post-operative mechanical ventilation, neonatal age, low birth weight, co-morbidities, including malformations of other body systems.

Background. The topic relevance is determined by the increasing number of children with congenital heart defect (CHD) who require surgical correction at an early age. For further follow-up it is necessary to determine a functional status of the cardiovascular system (CVS), its adaptation to new conditions of hemodynamics, that is especially important in childhood during the period of morphological and functional changes in the growing organism. Aim. To assess the functional status of the CVS in children with CHD using a test with dosed exercise load (EL) to determine the need for an individual approach to physical rehabilitation.Materials and methods. The study included 80 children, who have been surgically treated for CHD by the age of 1 year. The study population included 32 (40.0%) boys and 48 (60.0%) girls; an average age of patients was 33.5 ± 4.28 months. The control group included 50 conditionally healthy children, with an average age of 35.0 ± 4.1 months; of which 23 (46%) were boys and 27 (54%) were girls. To assess the functional status of the CVS, a test with dosed EL was performed (10 squats in 20 s). Blood pressure and heart rate were measured at rest and after exercise, the double product and the quality of response index were calculated. Results. In children with CHD 2 years after surgery, resting blood pressure was lower compared with healthy children, no significant differences in heart rate between groups were found. The double product in children of the main group was close to above average value. Analysis of hemodynamic changes due to EL showed a more pronounced increase in heart rate and less pronounced increase in pulse pressure and stroke volume in children with CHD after correction, which indicates the adaptation of CVS to EL due to an increase in the rate rather than the strength of heart contractions. The quality of response index in the group of children with CHD corresponded to an irrational reaction to EL. Analysis of CVS responses to the load showed that the most prevalent type was asymptaticotonic one (when there is an increase in heart rate and almost no changes in blood pressure). In the hypertensive type (revealed in a small number of children), there is a significant increase in both heart rate and systolic and diastolic blood pressure. The time of hemodynamics backing up to the baseline parameters did not exceed 5 minutes in both groups, no child complained during the test. Conclusions. In young children who had surgical correction for septal CHD in infancy, blood pressure is characterized by low parameters, that is associated with a possible alteration in the regulation of vascular tone. The predominant type of the CVS response to EL in young children with septal CHD which was corrected in infancy is the asympathicotonic one with a normal period of restoration of hemodynamics to the baseline parameters. The test with EL allows us to individualize the program of physical rehabilitation of young children who had surgery for septal CHD in infancy, taking into account the status of CVS and the initial fitness

The aim – to investigate the anatomic variants of the coronary arteries (CA) in children with different forms of congenitally corrected transposition of the great arteries (CC-TGA). Materials and methods. 93 children with CC-TGA were observed since January 2007 to December 2017. To determine the anatomy of the coronary arteries coronary angiography was performed in 49 (52 %) patients with different anatomical variants of CC-TGA. Results. The most frequent coronary anatomy was anatomy in which the right coronary artery (RCA) arose the sinus of the right hand (first sinus), and the left coronary artery (LCA) arose the sinus of the left hand (second sinus) and then divided into the left anterior descending artery (LAD) and the circumflex artery (Cx). Anatomy where the origin of coronary arteries from a single sinus was found in 4 (8.1 %) patients: in one patient all arteries arose from the sinus of the left arm, and in the remaining three patients – from the sinus of the right arm. Origin of RCA from LCA (RCA posterior loop anatomy) was found in one patient. Conclusions. Pattern in which the right coronary artery arose the sinus of the right hand (first sinus), and the left coronary artery arose the sinus of the left hand (second sinus) and then divided into the left anterior descending artery and the circumflex artery was the most frequent in patient with CC-TGA. Coronary angiography is of great importance in the preparation to cardiac surgery in patients with CC-TGA due to the variability of the coronary anatomy

Syndrome of abnormal originating of the left coronary artery from pulmonary artery (ALCAPA), or Bland-White-Garland syndrome, is an inborn heart defect of atypical coronary arteries branching. In most cases this anomaly is revealed in infancy or adolescence. Opinions exist, that the anomaly is much more prevalent than it is diagnosed. Even more, it might be a cause of myocardial infarction and sudden death of 1st year newborns. In the article, a clinical case presented of first time revealed ALCAPA in 64 year old woman.

In order to prevent children morbidity and mortality 116 children aged from 6 months to 5 years from 2 risk groups (1 — with bronchial-pulmonary dysplasia and 2 — with congenital heart defects) were vaccinated with pneumococcal 7-valent conjugated vaccine in 2011 at the expense of municipal budget. Among 116 children from both groups 16 (14%) have had community-acquired pneumonia, which is 22 times higher than in general children population in this region. Dynamic 1-year follow-up showed significant decrease of community-acquired pneumonia prevalence in risk groups: from 16/116 (14%) to 1/75 (1%) (p =0,006). There were no cases of invasive pneumococcal infections among vaccinated children and in 87,5% of them the general morbidity decreased. The frequency of moderate general post-vaccinal reactions was 1,8%, topical reactions — 0,9%. There were no other side effects during post-vaccinal period. Thereafter, the vaccination against pneumococcal infection performed in Novosibirsk in children with risk of fatal complications showed high efficacy and safety of the used vaccine.

Sydorenko A. Yu., Kurkevych А. К., Markova М. V. Peculiarities of psychoemotional condition of pregnant women before foetus echocardiography and parents’ reaction to the prenatal diagnosis = Особенности психоэмоционального состояния беременных перед эхокардиографическим исследованием плода и реакции родителей на пренатальный диагноз. Journal of Education, Health and Sport. 2015;5(10):69-78. ISSN 2391-8306. DOIhttp://dx.doi.org/10.5281/zenodo.32031 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%2810%29%3A69-78 https://pbn.nauka.gov.pl/works/654278 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011–2014http://journal.rsw.edu.pl/index.php/JHS/issue/archive Deklaracja. Specyfika i zawartość merytoryczna czasopisma nie ulega zmianie. Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., że w roku 2014 nie będzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktów co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r. The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014). © The Author (s) 2015; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 02.08.2015. Revised 05.09.2015. Accepted: 29.09.2015. УДК 616.89-008-053.2+616.12-089-053.2-092 PECULIARITIES OF PSYCHOEMOTIONAL CONDITION OF PREGNANT WOMEN BEFORE FOETUS ECHOCARDIOGRAPHY AND PARENTS’ REACTION TO THE PRENATAL DIAGNOSIS ОСОБЕННОСТИ ПСИХОЭМОЦИОНАЛЬНОГО СОСТОЯНИЯ БЕРЕМЕННЫХ ПЕРЕД ЭХОКАРДИОГРАФИЧЕСКИМ ИССЛЕДОВАНИЕМ ПЛОДА И РЕАКЦИИ РОДИТЕЛЕЙ НА ПРЕНАТАЛЬНЫЙ ДИАГНОЗ A. Yu. Sydorenko, А. К. Kurkevych, М. V.Markova А. Ю. Сидоренко, А. К. Куркевич, М. В. Маркова Scientific-Practical Medical Center for Pediatric Cardiology and Cardiac Surgery Kharkiv Medical Academy of Postgraduate Education Научно-практический медицинский центр детской кардиологии и кардиохирургии МЗ Украины, Киев Харьковская медицинская академия последипломного образования МЗ Украины Summary Currently the scientific works focus on a significant maternal and paternal psychological distress after the prenatal diagnosis. The aim of our study was to determine the volume and goals of medical and psychological help to the pregnant women suspected of congenital heart disease in the foetus. The study was conducted at the state-run Scientific and Practical Medical Children’s Cardiology andCardiosurgeryCenterof the Ukrainian Health Ministry. 21 pregnant women before and after echocardiography foetus examination and 9 men were interviewed. It was found that 62% of pregnant women and 50% of husbands displayed subclinical and clinical levels of anxiety and depression before the echocardiography examination. The results highlighted that married couple who learned the prenatal congenital heart disease diagnosis need the relevant follow up program. This program could include a consultation with the psychologist and the possible excess to enlarged database of educational materials. Key words: prenatal diagnosis, congenital heart defect, anxiety, depression, medical and psychological assistance. Реферат Все чаще в литературе стали появляться работы посвященные значительному материнскому и отцовскому психологическому дистрессу после пренатального диагноза. Целью исследования было определение объемов и мишеней медико-психологической помощи беременным женщинам, у которых подозревается врожденный порок сердца у плода. Исследование проводилось на базе ГУ «Научно-практический медицинский центр детской кардиологии и кардиохирургии МЗ Украины». Было обследовано 21 беременную женщину до и после эхо-кардиографического исследования сердца плода и 9 мужчин (супругов). Было обнаружено, что у 62% беременных женщин и у 50% мужчин наблюдался субклинический и клинический уровень тревоги и депрессии перед эхо-кардиографическим обследованием. В статье отмечается, что супруги, получившие пренатальный диагноз ВВС у плода требует соответствующей сопроводительной программы, которая бы включала возможность консультации с психологом, а также возможность доступа к расширенной базе обучающих материалов. Ключевые слова: пренатальный диагноз, врожденный порок сердца, тревога, депрессия, медико-психологическая помощь.

Dudnyk V. M., Zborowskay O. O. Ефективність фармакологічної корекції міокардіальної дисфункції у дітей з вродженими вадами серця після оперативного лікування = Effectiveness of myocardial dysfunction pharmacological correction in children with congenital heart disease after surgical treatment. Journal of Education, Health and Sport. 2015;5(4):117-128. ISSN 2391-8306. DOI: 10.5281/zenodo.16665 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%284%29%3A117-128 https://pbn.nauka.gov.pl/works/553516 http://dx.doi.org/10.5281/zenodo.16665 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011 – 2014 http://journal.rsw.edu.pl/index.php/JHS/issue/archive Deklaracja. Specyfika i zawartość merytoryczna czasopisma nie ulega zmianie. Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., że w roku 2014 nie będzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktów co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r. The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014). © The Author (s) 2015; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 20.01.2014. Revised 27.03.2015. Accepted: 27.03.2015. УДК 616.248 – 053:611.018.74:616 – 008.6 ЕФЕКТИВНІСТЬ ФАРМАКОЛОГІЧНОЇ КОРЕКЦІЇ МІОКАРДІАЛЬНОЇ ДИСФУНКЦІЇ У ДІТЕЙ З ВРОДЖЕНИМИ ВАДАМИ СЕРЦЯ ПІСЛЯ ОПЕРАТИВНОГО ЛІКУВАННЯ EFFECTIVENESS OF MYOCARDIAL DYSFUNCTION PHARMACOLOGICAL CORRECTION IN CHILDREN WITH CONGENITAL HEART DISEASE AFTER SURGICAL TREATMENT В. М. Дудник, О. О. Зборовська V. M. Dudnyk, O. O. Zborowskay Вінницький національний медичний університет ім.М.І.Пирогова Vinnitsa National Medical University, Vinnytsya Abstract Background. Among children with congenital heart disease (CHD) undergoing cardiac surgery the incidence of heart failure (HF) is 61.4%. The main goal in myocardial dysfunction medication is to create conditions for adequate cardiac output (afterload) and a decrease in the volume filling chambers of the heart (preload). The study of metabolic reactions in the myocardium by pathological conditions increases the interest in drugs that are endogenous regulators of energy metabolism. The aim of our study was to evaluate the effectiveness of myocardial dysfunction pharmacological correction in children with congenital heart disease after surgical treatment. Materials and methods. We examined 184 child from the CHD, which was made radical correction of anatomical defects aged 1 month to 18 years (mean age 9,42 ± 3,43 years). CHD belonged to different hemodynamic types, namely 119 children (64,67 ± 3,52%) had a bug with the enrichment of the pulmonary circulation (EPC); 35 children (19,02 ± 2,89%) - with the depletion of the EPC and 30 children (16,00 ± 2,72%) - CHD depletion of systemic circulation. Children with every type CHD were divided into two groups, representative by age, sex, postoperative experience. In the study group in addition to the basic treatment of heart failure children receiving therapy with Ahvantar (oral 100 mg / kg per day, 30 days). All children performed echocardiography examination using tissue doplerohraifiyi to assess longitudinal wall motion of the left and right ventricles of the heart in different phases cycle. Results and discussion. Children with primary research group had significantly better clinical dynamics than those of the comparison group, namely for all types of BBC incidence of heart failure symptoms in children of the main group decreased in 2,14-5,00 times. Adding to the treatment regimen of L-carnitine in children of the main group was accompanied by improved contractile parameters of left ventricular performance and S`mshp S` microns to 16,17-35,91%, and the right amplitude TAPSE and S` maybe 17,31- 21.71%. Joining kardiometabolitnoyi therapy to the basic treatment of heart failure in children and the CHD core group of blood circulation in the IWC mainly improved diastolic function of the right ventricle in terms of E / E`tk to 17,88-31,64%, while the Air Force of the depletion reduced the systemic circulation values of E / E`mshp and E / E`mk to 23.80% and 47.41%, respectively, which significantly differed from those of the comparison group received after treatment. Conclusion. Correction of myocardial dysfunction in children with BBC after surgical correction requires a differentiated approach, depending on the type of hemodynamic disorders in a large and a small circle of blood circulation. Keywords: congenital heart defect, children, myocardial dysfunction, treatment. Реферат Актуальність проблеми. Серед дітей з вродженими вадами серця (ВВС), що перенесли кардіохірургічне втручання частота виникнення серцевої недостатності (СН) становить 61,4 %. Головною метою в медикаментозному лікуванні міокардіальної дисфункції є створення умов для адекватного серцевого викиду (постнавантаження) та зменшенням об’ємного наповнення камер серця (переднавантаження). Дослідження обмінних реакцій в міокарді за патологічних умов підвищує інтерес до препаратів, що є ендогенними регуляторами енергетичного обміну. Метою нашого дослідження було оцінити ефективність фармакологічної корекції міокардіальної дисфункції у дітей з вродженими вадами серця після оперативного лікування. Матеріали та методи. Нами обстежено 184 дитини з ВВС, котрим була виконана радикальна корекція анатомічних дефектів у віці від 1 місяця до 18 років (середній вік 9,42±3,43 років). ВВС відносились до різних гемодинамічних типів, а саме 119 дітей (64,67±3,52 %) мали ваду із збагаченням малого кола кровообігу (МКК); 35 дітей (19,02±2,89 %) – із збідненням МКК та 30 дітей (16,00±2,72%) – ВВС із збідненням системного кола кровообігу. Діти з кожним типом ВВС поділялись на дві групи, репрезентативні за віком, статтю, післяопераційним стажем. В основній групі крім базисної терапії СН діти отримували кардіометаболітну терапію препаратом Агвантар (перорально 100 мг/кг на добу, 30 днів.) Усім дітям проводили ЕХО-КГ обстеження з використанням тканинної доплерограіфії для оцінки поздовжнього руху стінок лівого і правого шлуночків в різні фази серцевого циклу. Результати та їх обговорення. Діти із основної групи дослідження мали достовірно кращу клінічну динаміку, ніж діти з групи порівняння, а саме при всіх типах ВВС частота виникнення симптомів СН у дітей основної групи знизилась в 2,14-5,00 рази. Додавання до схеми лікування L-карнітину у дітей основної групи супроводжувалось покращенням показників скоротливої функції лівого шлуночку за показниками S`мшп та S` мкна 16,17-35,91 %, а правого за амплітудою TAPSE та S` тк17,31-21,71 %. Приєднання кардіометаболітної терапії до базисного лікування СН у дітей основної групи та ВВС із порушенням кровообігу в МКК переважно покращувало діастолічну функцію правого шлуночку за показником E/Е`тк на 17,88-31,64 %, а при ВВС із збідненням системного кола кровообігу знижувало значення E/Е`мшп таE/Е`мк на 23,80 % та 47,41 %, відповідно, що достовірно відрізняло їх від показників групи порівняння отриманими після лікування. Висновок. Корекція міокардіальної дисфункції у дітей з ВВС після оперативної корекції потребує диференційованого підходу, залежно від типу гемодинамічних порушень по великому та малому колу кровообігу. Ключові слова: вроджена вада серця, діти, міокардіальна дисфункція, лікування.

Background: Surgical treatment of 'blue' congenital heart defects frequently implies various interventions on the outlet portion of the right ventricle or pulmonary artery trunk. Most often used are various conduits, reconstructing the outlet portion of the right ventricle and pulmonary artery. Most patients having previously endured the mentioned interventions, would in the remote terms require repeat operative procedures for stenosis or insufficiency on the pulmonary valve or the implanted conduit. Taking into account complexity and the risk of open interventions, the current trends are towards more frequent use of transcatheter implantation of the pulmonary valve., Aim: The purpose of this work is to present the first serial experience with hybrid transventricular implantation of an original Russian-made valve into the position of the pulmonary artery., Patients and Methods: We retrospectively studied a series of 5 clinical cases who from July 2019 to May 2020 at the Federal Centre of Cardiovascular Surgery (Penza) had underwent hybrid transventricular implantation of the first Russian-made valve-containing stent (MedLab-KT) into the position of the pulmonary valve, with the stent's closing component consisting of leaflets made of polytetrafluoroethylene., Results: 3 patients underwent implantation of valve # 25 and 2 subjects received valve # 23, with all cases yielding good immediate results. The haemodynamic parameters of the implanted prosthesis were optimal. In all cases, the significant gradient was absent and regurgitation did not exceed grade I. There was no in-hospital mortality. The method of hybrid prosthetic repair of the pulmonary valve via the transapical right-ventricular access from the left lateral mini-thoracotomy was aimed at reducing potential risks of artificial circulation, also contributing to a significant decrease in the traumatic nature of surgical treatment of patients requiring a repeat intervention for pulmonary valve pathology.