Year 2021 Vol. 29 No 5

CASE REPORTS

D.K. GUSCHIN, S.S. VOLKOV, A.V. SHCHERBAK, M.M. ZELENIKIN

EFFECTIVE CORRECTION OF THE COMMON ATRIOVENTRICULAR CANAL WITH TETRALOGY OF FALLOT AND HYPOPLASIA OF THE RIGHT VENTRICLE IN A CHILD

A.N. Bakoulev National Medical Research Center for Cardiovascular Surgery of the Ministry of Health of the Russian Federation, Moscow,
The Russian Federation

The paper presents a description of a case of successful one and a half ventricular correction of a complex congenital cardiac anomalies, including the common atrioventricular canal, tetralogy of Fallot, and hypoplasia of the right ventricle in a child (2 year and 4 months). A rare congenital anomaly characterized by a combination of intracardiac defects, required an innovative surgical approach, the exclusivity of this clinical case has determined.
The surgical strategy of complete atrioventricular canal defect is determined by a number of factors. One of the most important is balance between right and left ventricular outputs. The balanced type with adequate development of the ventricles involves the biventricular repair performance. Unbalanced atrioventricular canal defects include a hypoplastic ventricle. Reconstructive surgery for one hypoplastic ventricle is oriented towards the degree of hypoplasia. In particular, a mild right ventricular hypoplasia allows perfoming biventricular radical operation while a severe degree suggests univentricular repair. In case of borderline, moderate degree of hypoplastic right ventricle the one and half ventricle repair can be carried out. Another important point is the presence of concomitant pulmonic stenosis required the choice of optimal method and material for reconstruction which is not always obvious and often it is the subject of debates. This report presents a description of the diagnostic stages with an emphasis on determining the type of balance of the common atrioventricular canal, the degree of hypoplasia of the right ventricle, the approach to choosing the optimal method for correcting the defect in general and the material for reconstructing the outflow pathway from the right ventricle in particular, as well as the subsequent successful correction of congenital multicomponent cardiac abnormalities in a young patient.

Keywords: young children, complete atrioventricular canal defect, tetralogy of Fallot, one and half ventricle repair, pulmonary allograft
p. 629-635 of the original issue
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Address for correspondence:
121552, The Russian Federation,
Moscow, Rublevskoe Highway, 135,
A.N. Bakoulev National Medical
Research Center for Cardiovascular Surgery,
Surgery Department of Young Children
With Congenital Heart Diseases,
Tel. mobile: +79260310316,
e-mail: medikum@inbox.ru,
Dmitry K. Guschin
Information about the authors:
Guschin Dmitriy K., Researcher, Cardiovascular Surgeon of the Department of Congenital Heart Diseases Surgery in Young Children, .N. Bakoulev National Medical Research Center for Cardiovascular Surgery of the Ministry of Health of the Russian Federation, Moscow, the Russian Federation.
http://orcid.org/0000-0002-0925-6526.
Volkov Sergey S., PhD, Senior Researcher, Cardiovascular Surgeon of the Department of Congenital Heart Diseases Surgery in Young Children, .N. Bakoulev National Medical Research Center for Cardiovascular Surgery of the Ministry of Health of the Russian Federation, Moscow, the Russian Federation.
http://orcid.org/0000-0003-2005-4957.
Shcherbak Anastasia V., Cardiovascular Surgeon of the Department of Congenital Heart Diseases Surgery in Young Children, .N. Bakoulev National Medical Research Center for Cardiovascular Surgery of the Ministry of Health of the Russian Federation, Moscow, the Russian Federation.
http://orcid.org/0000-0002-0723-9028.
Zelenikin Mikhail M., MD, Professor, Chief of the Department of Congenital Heart Diseases Surgery in Young Children,.N. Bakoulev National Medical Research Center for Cardiovascular Surgery of the Ministry of Health of the Russian Federation, Moscow, the Russian Federation. http://orcid.org/0000-0002-1298-2940.
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