Аннотация
Врожденные пороки сердца (ВПС) являются одними из самых частых жизнеугрожающих врожденных заболеваний. Однако прогноз при таких заболеваниях может быть еще серьезнее при наличии экстракардиальных патологий, среди которых особенно часто с ВПС сочетаются врожденные пороки развития (ВПР) желудочно-кишечного тракта (ЖКТ). Подобное сочетание заболеваний требует быстрого и верного принятия решения в отношении хирургического лечения в первые дни жизни ребенка. Даже в изолированном виде эти заболевания могут стать показанием для экстренного или срочного хирургического вмешательства с применением этапного или первично-радикального подходов. Однако на сегодняшний день не существует универсального алгоритма лечения пациентов с подобным сочетанием врожденных заболеваний. В данной работе продемонстрированы клинические особенности сочетания ВПС и ВПР ЖКТ, которые обусловливают необходимость формирования оптимальных диагностических и лечебных алгоритмов для этой непростой группы пациентов.
Литература
- Christianson A., Howson C.P., Modell B. March of Dimes: global report on birth defects, the hidden toll of dying and disabled children. New York; 2006.
- Sixty-third World Health Assembly Provisional Agenda item 11.7. Geneva: World Health Organization; 2010.
- Mitchell S.C., Korones S.B., Berendes H.W. Congenital heart disease in 56,109 births. Incidence and natural history. Circulation. 1971; 43 (3): 323–32. DOI: 10.1161/01.cir.43.3.323
- Dolk H., Loane M., Garne E. European Surveillance of Congenital Anomalies (EUROCAT) working group. Congenital heart defects in Europe: prevalence and perinatal mortality, 2000 to 2005. Circulation. 2011; 123 (8): 841–9. DOI: 10.1161/circulationaha.110.958405
- Bosi G., Garani G., Scorrano M., Calzolari E., Party T.I.W. IMER Working Party. Temporal variability in birth prevalence of congenital heart defects as recorded by a general birth defects registry. J. Pediatr. 2003; 142 (6): 690–8. DOI: 10.1067/mpd.2003.243
- Jenkins K.J., Correa A., Feinstein J.A., Botto L., Britt A.E., Daniels S.R. et al. American Heart Association Council on Cardiovascular Disease in the Young. Noninherited risk factors and congenital cardiovascular defects: current knowledge: a scientific statement from the American Heart Association Council on Cardiovascular Disease in the Young: endorsed by the American Academy of Pediatrics. Circulation. 2007; 115 (23): 2995–3014. DOI: 10.1161/CIRCULATIONAHA.106.183216
- Anderson R., Smith B. Deaths: leading causes for 2002. Natl. Vital. Stat. Rep. 2005; 53 (17): 1–89. PMID: 15786629
- Dickinson D., Arnold R., Wilkinson J. Congenital heart disease among 160 480 liveborn children in Liverpool 1960 to 1969. Implications for surgical treatment. Br. Heart J. 1981; 46 (1): 55–62. DOI: 10.1136/hrt.46.1.55
- Grech V., Gatt M. Syndromes and malformations associated with congenital heart disease in a population-based study. Int. J. Cardiol. 1999; 68 (2): 151–6. DOI: 10.1016/s0167-5273(98)00354-4
- HCUP Nationwide Inpatient Sample (NIS) (2013) Healthcare Cost and Utilization Project (HCUP), 1998–2008; Agency for Healthcare Research and Quality. http://www.hcup-us.ahrq.gov/nisoverview.jsp (дата обращения 22.10.2013).
- Egbe A., Uppu S., Lee S., Ho D., Srivastava S. Prevalence of associated extracardiac malformations in the congenital heart disease population. Pediatr. Cardiol. 2014; 35 (7): 1239–45. DOI: 10.1007/s00246-014-0922-6
- Wojtalik M., Mrówczyński W., Henschke J., Wronecki K., Siwińska A., Piaszczyński M. et al. Congenital heart defect with associated malformations in children. J. Pediatr. Surg. 2005; 40: 1675–80.
- Rosa R.C.M., Rosa R.F.M., Zen P.R.G., Paskulin G.A. Congenital heart defects and extracardiac malformations. Rev. Paul. Pediatr. 2013; 31 (2): 243–51. DOI: 10.1590/s0103-05822013000200017
- Mery C.M., De León L.E., Rodriguez J.R., Nieto R.M., Zhang W., Adachi I. et al. Effect of gastrointestinal malformations on the outcomes of patients with congenital heart disease. Ann. Thorac. Surg. 2017; 104 (5): 1590–6. DOI: 10.1016/j.athoracsur.2017.04.042
- Pedersen R.N., Calzolari E., Husby S., Garne, E. EUROCAT Working group. Oesophageal atresia: prevalence, prenatal diagnosis and associated anomalies in 23 European regions. Arch. Dis. Child. 2012; 97 (3): 227–32. DOI: 10.1136/archdischild-2011-300597
- Cassina M., Ruol M., Pertile R., Midrio P., Piffer S., Vicenzi V. et al. Prevalence, characteristics, and survival of children with esophageal atresia: a 32-year population-based study including 1,417,724 consecutive newborns. Birth Defects Res. Clin. Mol. Teratol. 2016; 106 (7): 542–8. DOI: 10.1002/bdra.23493
- Herman R.S., Teitelbaum D.H. Anorectal malformations. Clin. Perinatol. 2012; 39: 403–22. DOI: 10.1016/j.clp.2012.04.001
- Nasr A., McNamara P.J., Mertens L., Levin D., James A., Holtby H. et al. Is routine preoperative 2-dimensional echocardiography necessary for infants with esophageal atresia, omphalocele, or anorectal malformations? J. Pediatr. Surg. 2010; 45 (5): 876–9. DOI: 10.1016/j.jpedsurg.2010.02.002
- Best K.E., Tennant P.W., Addor M.C., Bianchi F., Boyd P., Calzolari E. et al. Epidemiology of small intestinal atresia in Europe: a register-based study. Arch. Dis. Child. Fetal Neonatal Ed. 2012; 97 (5): F353–8.
- Bethell G.S., Long A.M., Knight M., Hall N.J. Congenital duodenal obstruction in the UK: a population-based study. Arch. Dis. Child. Fetal Neonatal Ed. 2020; 105 (2): 178–83.
- Choudhry M.S., Rahman N., Boyd P., Lakhoo K. Duodenal atresia: associated anomalies, prenatal diagnosis and outcome. Pediatr. Surg. Int. 2009; 25 (8): 727–30.
- Badner J.A., Sieber W.K., Garver K.L., Chakravarti A.R. A genetic study of hirschsprung disease. Am. J. Hum. Gen. 1990; 46 (3): 568.
- Prato A.P., Rossi V., Mosconi M., Holm C., Lantieri F., Griseri P. et al. A prospective observational study of associated anomalies in Hirschsprung’s disease. Orph. J. Rare Dis. 2013; 8 (1): 1–2.
- Sadler T.W., Langman J. Third to eighth weeks: the embryonic period. In: Langman's medical embryology. Wolters Kluwer, Lippincott Williams & Wilkins, Philadelphia; 2012: 43–85.
- Marguerie A., Bajolle F., Zaffran S., Brown N.A., Dickson C., Buckingham M.E. et al. Congenital heart defects in Fgfr2-IIIb and Fgf10 mutant mice. Cardiovasc. Res. 2006; 71 (1): 50–60. DOI: 10.1016/j.cardiores.2006.03.021
- Leonard H., Barrett A.M., Scott J.E.S., Wren C. The influence of congenital heart disease on survival of infants with oesophageal atresia. Arch. Dis. Child. Fetal Neonatal Ed. 2001; 85 (3): F204–6. DOI: 10.1136/fn.85.3.f204
- Waterston D.J., Carter R.E., Aberdeen E. Oesophageal atresia: tracheo-oesophageal fistula. A study of survival in 218 infants. Lancet. 1962; 1 (7234): 819–22. DOI: 10.1016/s0140-6736(62)91837-8
- Poenaru D., Laberge J.M., Neilson I.R., Guttman F.M. A new prognostic classification for esophageal atresia. Surgery. 1993; 113 (4): 426–32. PMID: 8456399
- Spitz L., Kiely E.M., Morecroft J.A., Drake D.P. Oesophageal atresia: at-risk groups for the 1990s. J. Pediatr. Surg. 1994; 29 (6): 723–5. DOI: 10.1016/0022-3468(94)90354-9
- Sugito K., Koshinaga T., Hoshino M., Inoue M., Goto H., Ikeda T. et al. Study of 24 cases with congenital esophageal atresia: what are the risk factors? Pediatr. Int. 2006; 48 (6): 616–21. DOI: 10.1111/j.1442-200X.2006.02288.x
- Jonker J.E., Liem E.T., Elzenga N.J., Molenbuur B., Trzpis M., Broens P.M. Congenital anorectal malformation severity does not predict severity of congenital heart defects. J. Pediatr. 2016; 179: 150–3.e1. DOI: 10.1016/j.jpeds.2016.08.047
- Abadi S.A., Abadi N.A., Mashrabi O., Fatorachi H. Congenital heart anomalies in babies with imperforate anus and its motility. Res. J. Biol. Sci. 2008; 3: 922–4.
- Elshazali H.O.H., Elshazali O.H., Elshazali H. The relationship between birth weight and congenital heart disease at Ahmed Gasim Cardiac Centre, Bahri, Sudan. Sudan J. Pediatr. 2017; 17 (2): 49–55. DOI: 10.24911/SJP.2017.2.6
- Chung S.H., Kim C.Y., Lee B.S., and the Korean Neonatal Network. Congenital anomalies in very-low-birth-weight infants: a nationwide cohort study. Neonatology. 2020; 117 (5): 584–91. DOI: 10.1159/000509117
- Kramer H.H., Trampisch H.J., Rammos, S., Giese A. Birth weight of children with congenital heart disease. Eur. J. Pediatr. 1990; 149 (11): 752–7. DOI: 10.1007/BF01957272
- De Hingh Y.C., van der Vossen P.W., Gemen E.F., Mulder A.B., Hop W.C., Brus F. et al. Intrinsic abnormalities of lymphocyte counts in children with down syndrome. J. Pediatr. 2005; 147 (6): 744–7. DOI: 10.1016/j.jpeds.2005.07.022
- Ram G., Chinen J. Infections and immunodeficiency in Down syndrome. Clin. Exp. Immunol. 2011; 164 (1): 9–16. DOI: 10.1111/j.1365-2249.2011.04335.x
- Delany D.R., Gaydos S.S., Romeo D.A., Henderson H.T., Fogg K.L., McKeta A.S. et al. Down syndrome and congenital heart disease: perioperative planning and management. J. Congenit. Cardiol. 2021; 5 (1): 1–14.
- Serraf A., Bensari N., Houyel L., Capderou A., Roussin R., Lebret E. et al. Surgical management of congenital heart defects associated with heterotaxy syndrome. Eur. J. Cardiothorac. Surg. 2010; 38 (6): 721–7. DOI: 10.1016/j.ejcts.2010.02.044
- Ekenze S.O., Nwangwu E.I., Ezomike U.O. Congenital obstructive bowel anomalies presenting after neonatal age. Malawi Med. J. 2019; 31 (1): 77–81. DOI: 10.4314/mmj.v31i1.13
- Hohlschneider A.M., Hustson J.M. Nonurologic anomalies associated with anorectal malformations. In: Anorectal malformations in children. Springer, Berlin, Heidelberg; 2006: 263–8. DOI: 10.1007/978-3-540-31751-7_16
- Cheng W., Leung M.P., Tam P.K. Surgical intervention in necrotizing enterocolitis in neonates with symptomatic congenital heart disease. Pediatr. Surg. Int. 1999; 15 (7): 492–5. DOI: 10.1007/s003830050647
- Reilly P.M., Wilkins K.B., Fuh K.C., Haglund U., Bulkley G.B. The mesenteric hemodynamic response to circulatory shock: an overview. Shock. 2001; 15 (5): 329–43. DOI: 10.1097/00024382-200115050-00001
- Aneman A., Pettersson A., Eisenhofer G., Friberg P., Holm M., Von Bothmer C. Sympathetic and renin-angiotensin activation during graded hypovolemia in pigs: impact on mesenteric per- fusion and duodenal mucosal function. Shock. 1997; 8: 378–84.
- Baird R., Laberge J.M., Lévesque D. Anastomotic stricture after esophageal atresia repair: a critical review of recent literature. Eur. J. Pediatr. Surg. 2013; 23 (3): 204–13. DOI: 10.1055/s-0033-1347917
- Stenström P., Salö M., Anderberg M., Arnbjörnsson E. Congenital heart disease and its impact on the development of anastomotic strictures after reconstruction of esophageal atresia. Gastroenterol. Res. Pract. 2018; 2018: 6021014. DOI: 10.1155/2018/6021014
- Güney L.H., Araz C., Beyazpınar D.S., Arda . I.S., Arslan E.E., Hiçsönmez A. Abdominal problems in children with congenital cardiovascular abnormalities. Balkan Med. J. 2015; 32 (3): 285–90. DOI: 10.5152/balkanmedj.2015.151045
- Diaz L.K., Akpek E.A., Dinavahi R., Andropoulos D.B. Tracheoesophageal fistula and associated congenital heart disease: implications for anesthetic management and survival. Paediatr. Anaesth. 2005; 15 (10): 862–9. DOI: 10.1111/j.1460-9592.2005.01582.x
- Adler A.C., Steven J.M., Jolley M.A. Anesthetic management of a tracheoesophageal fistula in a patient with a large uncorrected aortopulmonary window: a case report. Case Rep. 2017; 8 (7): 172–4. DOI: 10.1213/XAA.0000000000000460
- Thomas J. Anaesthesia for the child with congenital heart disease: pointers and pitfalls. Continuing Med. Ed. 2011; 29: 463–6.
- Bishay M., Retrosi G., Horn V., Cloutman-Green E., Harris K., de Coppi P. et al. Septicaemia due to enteric organisms is a later event in surgical infants requiring parenteral nutrition. Eur. J. Pediatr. Surg. 2012; 22 (01): 050–3.
- Schierz I.A.M., Pinello G., Giuffrè M., La Placa S., Piro E., Corsello G. Congenital heart defects in newborns with apparently isolated single gastrointestinal malformation: A retrospective study. Early Hum. Dev. 2016; 103: 43–7. DOI: 10.1016/j.earlhumdev.2016.07.005
- Gonzalez J.H., Shirali G.S., Atz A.M., Taylor S.N., Forbus G.A., Zyblewski S.C. et al. Universal screening for extracardiac abnormalities in neonates with congenital heart disease. Pediatr. Cardiol. 2009; 30 (3): 269–73. DOI: 10.1007/s00246-008-9331-z
- Murugasu B., Yip W.C., Tay J.S., Kit-Yee C., Hui-Kim Y., HockBoon W. Sonographic screening for renal tract anomalies associated with congenital heart disease. J. Clin. Ultrasound. 1990; 18 (2): 79–83. DOI: 10.1002/jcu.1870180203
- Greenwood R.D., Rosenthal A., Parisi L., Fyler D.C., Nadas A.S. Extracardiac abnormalities in infants with congenital heart disease. Pediatrics. 1975; 55 (4): 485–92. PMID: 124046
Об авторах
- Япринцев Валерий Олегович, сердечно-сосудистый хирург, мл. науч. сотр.; ORCID
- Яцык Сергей Павлович, д-р мед. наук, профессор, чл.-корр. РАН, директор Института детской хирургии; ORCID
- Мовсесян Рубен Рудольфович, д-р мед. наук, профессор, чл.-корр. РАН, заведующий отделением; ORCID