Abstract
Introduction. In the long term after anatomic correction of transposition of the great arteries (TGA) the big problem is the patients
with residual stenosis of PA. Objective: To present the results of elimination of stenosis PA after anatomic correction transposition of
the great arteries.
Material and methods. In the Department of surgery of congenital heart defects in children older Bakulev Scientific Center of cardiovascular surgery re-operation was performed in 27 patients. In 18 cases the narrowing at the level of the trunk PA, 9 other narrow
branches of PA. The systolic pressure gradient on PA 65,3 ± 19,6 mmHg, on the branches of PA 30,2 ± 8,3 mmHg. The average age
of patients was 4,4 ± 2,3 years. The interval between primary and secondary operations averaged 4,2 years.
Results. In 15 patients performed plastic PA xenopericardial patch, 12 patients completed TLBA followed residual stenosis of the
trunk and branches of PA. Mortality was 3,7% (1 patient died). After open surgery, the systolic pressure gradient on PA decreased
from 62,4 to 18,9 mmHg., after total TLBA followed the systolic pressure gradient between the right ventricle and branches of PA
decreased from 76,2 to 26,4 mmHg. The systolic pressure gradient in the place TLBA followed fell from 30,2 to 18,7 mmHg.
Conclusion. Stenosis PA after anatomical correction TGA may occur as a result of insufficient allocation of branches in PA, the small
size of the patch to create a neoPA, inadequately completed the reconstruction of PA. In some cases, it may be the anatomical substrate subvalvular stenosis PA: infundibular stenosis, bulging structures atrioventricular valve in the outlet venous ventricle.
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