Abstract
Treatment of newborns with univentricular hemodynamics in combination with an anomaly of pulmonary venous return in modern cardiac surgical publications has the worst correction results. According to different authors, postoperative mortality in this cohort of patients varies from 41,7 to 53%. The presence of obstruction of the venous outflow tract, as well as the serious condition of the newborn, are among the main factors that increase the risk of death in the postoperative period. This article presents a clinical case of a patient with a prenatally diagnosed combined heart disease in the form of a functionally single ventricle with a double outlet of the main vessels from it, mitral valve atresia, an intact atrial septum and an anomaly of venous return, in which the outflow of blood from the left atrium was carried out through a single fetal communication – stenotic cardinal vein. In order to stabilize the patient's condition, the newborn urgently underwent stenting of the stenotic section of the cardinal vein. However, due to the lack of positive dynamics in the postoperative period, the child underwent repeated endovascular intervention, and stenting of the intraoperatively created interatrial communication was performed. Given the absence of obstruction of the outflow tract to the pulmonary artery, it was necessary to perform an open surgical intervention in a short time – pulmonary artery banding. At the time of writing, the child successfully underwent the next stage of palliative correction – Glenn procedure. Thus, palliative endovascular intervention in critically ill neonates with univentricular hemodynamics and anomalous pulmonary venous return can be considered as a method of choice that can become a new safer strategy for managing infants in order to stabilize the condition before the main stage of surgical intervention.
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About the authors
- Artem V. Gorbatykh, Cand. Med. Sci., Chief of the Research Laboratory; ORCID
- Denis A. Manannikov, Resident; ORCID
- Igor' I. Averkin, Pediatric Cardiologist; ORCID
- Dmitriy D. Zubarev, Cand. Med. Sci., Head of the Department; ORCID
- Zukhriddin Zh. Makhsudov, Resident; ORCID
- Aleksandr A. Morozov, Cand. Med. Sci., Senior Researcher, Cardiovascular Surgeon; ORCID
- Mikhail A. Chernyavskiy, Dr. Med. Sci., Head of Department, Cardiovascular Surgeon; ORCID
