Abstract
Congenital and postoperative narrowing of pulmonary arteries represent a serious problem with hemodynamic correction by the
method of Fontaine in patients with univentricular anatomy of the heart. A special approach in the correction of hypoplasia and stenosis
in the pulmonary artery in the operating room, the hybrid method can significantly facilitate the approach to the narrowed section
and to perform a successful stent with the expansion of the branches of the pulmonary arteries. The article analyzes the first experience
in the treatment of stenosis of the pulmonary arteries with intraoperative stenting, hybrid three patients with complex congenital
heart defects. Successful stent implantation in all three patients made it possible to perform hemodynamic correction by the
method of Fontaine, without lethal outcomes. The analysis of treatment presented to the patients on topical issues of endovascular
treatment of congenital heart diseases hybrid method and corresponds to world tendencies of decision of this problem.
References
1. Mendelsohn A.M., Bove E.L., Lupinetti F.M., Crowley D.C.,
Lloyd T.R., Fedderly R.T., Beekman R.H., III. Intraoperative
and percutaneous stenting of congenital pulmonary artery and
vein stenosis. Circulation. 1993; 88 (pt 2): II-210–17.
2. Соболев А.В., Крюков В.А., Шаталов К.В. и др. Интраопе-
рационное стентирование периферического стеноза ле-
гочной артерии при радикальной коррекции сложного
врожденного порока сердца. Грудная и сердечно-сосудис-
тая хирургия. 1999; 3: 42–4 / Sobolev A.V., Kryukov V.A.,
Shatalov K.V. et al. Intraoperative stenting of peripheral pulmonary
artery stenosis in radical correction of complex congenital
heart disease. Grudnaya i Serdechno-Sosudistaya
Khirurgiya (Russian Journal of Thoracic and Cardiovascular
Surgery). 1999; 3: 42–4 (in Russ.)
3. Пурсанов М.Г. Транслюминальная балонная ангиопластика
и стентирование при обструктивной патологии легочных
артерий у больных с врожденными пороками сердца:
Дис. … д-ра мед. наук. М.; 2002 / Pursanov M.G.
Transluminal balloon angioplasty and stenting for obstructive
pathology of pulmonary arteries in patients with congenital
heart diseases: Dr. Med. Sci. Diss. Moscow; 2002 (in Russ.)
4. Алекян Б.Г., Подзолков В.П., Пурсанов М.Г. Стентирование
при сужениях и гипоплазиях легочных артерий. В кн.: Бо-
керия Л.А., Алекян Б.Г. (ред.) Руководство по рентгенэндо-
васкулярной хирургии сердца и сосудов. В 3 т. Т. 2. М.:
2008: 189–214 / Alekyan B.G., Podzolkov V.P., Pursanov
M.G. Stenting of the stenosis and hypoplasia of pulmonary
arteries. In: Bockeria L.A., Alekyan B.G. (eds) Guide to
endovascular surgery cardiac and vascular. In 3 vols. Vol 2.
Moscow; 2008 (in Russ.)
5. Ungeleider R.M., Johnston T.A., O'Laughlin M.P., Jaggers J.J.,
Gaskin P.R. Intraoperative stents to rehabilitate severely stenotic
pulmonary vessels. Ann. Thorac. Surg. 2001; 71: 476–81.
6. Bokenkamp R., Blom N.A., De Wolf D., Francois K.,
Ottenkamp J., Hazekamp M.G. Intraoperative stenting of pulmonary
arteries. Eur. J. Cardiothorac. Surg. 2005; 27: 544–7.
7. Mitropoulois F.A., Laks H., Kapadia N., Gurvitz M., Levi D.,
Williams R. et al. Intraoperative pulmonary artery stenting: An
alternative technique for the management of pulmonary artery
stenosis. Ann. Thorac. Surg. 2007; 84: 1338–41.
8. Chakraborty B., Hagler D., Burkhart H.M, Dearani J.A.
Intraoperative hybrid left pulmonary artery stenting. Ann.
Pediatr. Cardiol. 2013; 6 (1): 43–5.
9. Sridhar A., Subramanyan R., Premsekar R., Chidambaram S.,
Agarwal R., Manohar S.R., Cherian K.M. Hybrid intraoperative
pulmonary artery stenting in redo congenital cardiac surgeries.
Indian Heart J. 2014; 66 (1): 45–51.
10. Lynch W., Boekholdt S.M., Hazekamp M.G., de Winter R.J.,
Koolbergen D.R. Hybrid branch pulmonary artery stent placement
in adults with congenital heart disease. Interact.
Cardiovasc. Thorac. Surg. 2015; 20 (4): 499–503.
About the authors
- Pursanov Manolis Georgievich, Dr Med. Sc., Head of Department, Roentgenologist, orcid.org/0000-0002-1421-1795;
- Shatalov Konstantin Valentinovich, Dr Med. Sc., Professor, Head of Department, Cardiac Surgeon; Sobolev Andrey Vasil'evich, Cand. Med. Sc., Leading Researcher, orcid.org/0000-0002-0186-8165;
- Arnautova Irina Vladimirovna, Dr Med. Sc., Deputy Head of Department, Cardiac Surgeon, orcid.org/0000-0002-3204-3561;
- Timchenko Lyudmila Ivanovna, Cardiologist;
- Atazhanov Ulugbek Urazbaevich, Resident Physician;
- Zotov Dmitriy Vladimirovich, Anesthesiologist-Intensivist