Krasnoyarsk surgeons performed a very rare heart surgery to a newborn child

Doctors of the Federal Center for Cardiovascular Surgery of Krasnoyarsk Successfully performed a rare operation on the heart of the baby. He entered the hospital with a diagnosis of aortic coarctation with a defect in the interventricular partition ”a few days after birth.

It turned out that the atypical arrangement of the defect does not allow the radical correction by the usual method. “The routine practice in the correction of such a defect is the elimination of coarctation and the closure of the defect of the interventricular septum. But in this case, the picture was complicated by an atypical arrangement of the defect. When closing it, an obstacle was created on the path of blood flow from the left ventricle to the aorta. Therefore, after eliminating the aorta coarctation, a palliative (supportive) stage was performed – the narrowing of the pulmonary artery barrel to protect the lungs from hypervolemia associated with the defect of the interventricular septum, ”the doctors said.

Surgeons expected to wait for the age of 5-6 months so that the child would gain in mass and growth-in this case it would be easier to solve the question of how to close the defect and avoid obstruction (blood flow) on the path of outflow from the left ventricle to the aorta. But two months after the operation, obstruction was formed by itself due to an increase in the interventricular partition and there was no time to wait.

To save a small patient, surgeons used 3D printing technology.

“This is a very difficult situation, since it is almost impossible to eliminate obstruction at this age,” Pavel Teplov, head of the children's cardiac surgery department of the SSH of Krasnoyarsk, explains. – The easiest way of the solution is the transfer to one -year circulation, that is, the main ventricle is to make the right, not the left one, but this means dooming the child for life with one ventricle, in the presence of their full -fledged two. And this is unambiguous – disability with a not very optimistic forecast. It was decided to study all the options and find the way for radical defect correction. First of all, 3D reconstruction of the heart was performed to understand the location of the defect in relation to the vessels. It was revealed that the defect of the interventricular septum to the pulmonary artery is closest to redirect blood from the left ventricle into it. Thus, the treatment plan was formed – the operation of Yasui, the authorship of the Japanese surgeon. First, we redirected the blood from the left ventricle to the pulmonary artery with a patch, then combined the aorta and the pulmonary arteries together, and made a blood flow from the right ventricle to the lungs with the help of a homography. As a result, the child’s blood began to flow, like a healthy person. ”

It is noted that this is a very rare operation, the largest publication in world literature has no more than 20 cases. And in the Federal Cardiocenter of Krasnoyarsk, this was the second similar case.