RESUMEN
The method of prediction the enability of closure atrial septal defect before operation or in pre-bypass period during the one and one-half ventricle repair of CHD with hypoplastic right ventricle was presented. The method is based on comparison of the initial blood flow on superior vena cava (SVC) and right-to-left shunt at atrial level. Defect can be closed if flow on SVC and shunt flow are approximately equal. According to prognosis in 16 of 37 patients defect was closed. After operation there were not signes congestive heart insufficiensy and cyanosis. This approach allowes to avoid reoperations at least in half of patients. If shunt flow exceeds flow on SVC, defect must be left open.
Asunto(s)
Cardiopatías Congénitas/cirugía , Defectos del Tabique Interatrial/cirugía , Ventrículos Cardíacos/anomalías , Hemodinámica/fisiología , Venas Cavas/fisiopatología , Velocidad del Flujo Sanguíneo/fisiología , Puente Cardíaco Derecho , Cardiopatías Congénitas/complicaciones , Cardiopatías Congénitas/diagnóstico , Cardiopatías Congénitas/fisiopatología , Defectos del Tabique Interatrial/complicaciones , Defectos del Tabique Interatrial/diagnóstico , Defectos del Tabique Interatrial/fisiopatología , Ventrículos Cardíacos/fisiopatología , Ventrículos Cardíacos/cirugía , Humanos , Lactante , Recién Nacido , Cuidados Preoperatorios , Pronóstico , Resultado del TratamientoRESUMEN
Typical three-atrium heart constitute a rare inborn heart failure, in which pulmonary veins drain into the proximal additional camera of the left atrium, separated from distal left pericardium cavity of it own by diaphragm, in which there is one or more restrictive apertures. Of 6770 patients, consecutively operated on by one surgeon, in 15 (0.21%) ageing from 7 mo to 30 years the three-atrium heart was revealed. In all the patients the surgical correction of the failure was accomplished using artificial blood circulation. The early diagnosis and surgical treatment of the patients, suffering three-atrium heart failure, secures good late results and quality of life.
Asunto(s)
Deformidades Congénitas de la Mano/cirugía , Atrios Cardíacos/cirugía , Adolescente , Adulto , Niño , Preescolar , Ecocardiografía , Circulación Extracorporea , Deformidades Congénitas de la Mano/complicaciones , Deformidades Congénitas de la Mano/diagnóstico , Atrios Cardíacos/anomalías , Atrios Cardíacos/diagnóstico por imagen , Humanos , Hipertensión Pulmonar/diagnóstico , Hipertensión Pulmonar/etiología , Lactante , Calidad de Vida , Resultado del TratamientoRESUMEN
The issues of pathophysiology, diagnosis and surgical treatment of postoperative intraabdominal purulent-septic complications were suggested. Noncontrolled abortion of mediators with subsequent development of inflammation and damage in the organs, localized far from primary focus, constitutes the main factor of the postoperative intraabdominal purulent-septic complications occurrence. In such a situation the intraabdominal hypertension and abdominal compartment syndrome also promote the deepening of multiple dysfunctions of organs due to mechanical failure of functions in respiratory, hemodynamical, excretional systems of the organism, what promotes the development of vicious circles and the cascade reactions, leading to exitus lethalis. The modern strategy and tactics of complex treatment of such patients is enlighted.