Молодежный инновационный вестникМолодежный инновационный вестник2415-7805Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации8406UnclassifiedEVALUATION OF THE RESULTS OF VSD CORRECTION USING TRANSCUSPIDAL ACCESS IN CHILDREN UNDER 1 YEAR OF AGEAndreevIvan Alekseyevichiwan-andr.andreev@yandex.ruhttps://orcid.org/0000-0002-2072-1425Voronezh State Medical University named after N.N. Burdenko291220231228101402202318022023Copyright © 2023, Andreev I.A.2023<p><em>Relevance: Ventricular septal defect (VSD) is one of the most common congenital heart defects in children and occurs in 32% of patients with congenital heart disease.</em></p> <p><em>Objective: To evaluate the results of surgical correction of VSD in children under 1 year of age.</em></p> <p><em>Methods: We performed a retrospective documentation analysis of 48 patients under 1 year of age who were operated for perimembranous VSD in the cardiac surgery department of VRCH No.1 from 2016 to 2022. Patients were divided into 2 groups: in group 1 (n=22) the standard method of VSD closure was used; in group 2 (n=26) the technique of temporary TV septal flap dissection was used. Assessment of treatment outcomes adequacy was performed based on the criteria (presence of residual shunt, rhythm and conduction disturbances, presence of valve regurgitation) immediately before discharge and 36 months later. To account for distant results we used information from examinations conducted by pediatric cardiologists at the place of residence and at "VRCH №1". Objectivity of the evaluation was achieved due to the medical effectiveness index for each group.</em></p> <p><em>Results: The duration of artificial circulation and aortic clamping between the groups differed insignificantly (p0.05). At the time of hospital discharge, according to echocardiography, residual shunts greater than 3 mm in group 1 were in 3 children (13.6%) and in group 2 in 4 children (15.4%). Moderate tricuspid regurgitation in group 1 was observed in 10 patients (45.5%), and insufficiency of TV 2 was determined in 8 (36.4%) patients. In the 2nd group, moderate insufficiency of TV in 11 (42.3%) patients, insufficiency of TV of the 2nd degree in 11 (42.3%) patients. </em></p> <p><em>In the early postoperative period, implantation of permanent ACP was required in 1 (3.8%) patient in group 2 (complete AV-blockade). In the long-term period the patients did not require cardiac insufficiency therapy, no endocarditis of any etiology or rhythm disturbances requiring ACP inmplantation. No clinically significant TV insufficiency was detected in the groups. There were no lethality of cardiac pathology during the follow-up.</em></p> <p><em>Adequacy of correction: at discharge in 1 - 86.4%, in 2 - 80.8%; after 36 months in 1 - 100%, in 2 - 96.2%.</em></p> <p><em>Conclusions: The main result of VSD surgical treatment in the early and distant postoperative period is adequately performed correction. The use of transcuspidal access is effective in the surgical correction of VSD, the immediate and long-term results of which are comparable with the standard procedure in infants.</em></p>VSDtricuspid valveflap dissectionheart diseaseДМЖПтрикуспидальный клапанотсечение створкипороки сердца1.Бокерия Л.А., Ступаков И.Н., Самородская И.В., Юрлов И.А., Малхасян С.А. Дефект межжелудочковой перегородки: организационно-экономические аспекты. Детские болезни сердца и сосудов. 2009; 2: 4–7 / Bockeria L.A.,Stupakov I.N., amorodskaya I.V., Yurlov I.A., Malkhasyan S.A.Ventricular septal defect: organizational and economic issues. Detskie bolezni serdtsa i sosudov. 2009; 2: 4–7 (in Russ.).2.Schittek J, Sachweh JS, Arndt F, Grafmann M, Hüners I, Kozlik-Feldmann R, Biermann D. Outcomes of Tricuspid Valve Detachment for Isolated Ventricular Septal Defect Closure. Thorac Cardiovasc Surg. 2021 Dec;69(S 03):e48-e52. doi: 10.1055/s-0041-1735457. Epub 2021 Nov 10. PMID: 34758490; PMCID: PMC8601706.3.Ling Y, Bian X, Wang Y, Qian Y. Does tricuspid valve detachment improve outcomes compared with the non-tricuspid valve detachment approach in ventricular septal defect closure? Interact CardioVasc Thorac Surg 2020; doi:10.1093/icvts/ivaa289.4.Ю.А. Соболев, А.П. Медведев – Анализ причин и результатов повторных хирургических вмешательств после коррекции врожденных септальных дефектов сердца - Вестник новых медицинских технологий 3 (2014): 41-45. DOI: https://doi.org/10.12737/58955.Ça_atay Bilen, Gökmen Akkaya, Osman Nuri Tuncer and Yüksel Atay - Assessment of Tricuspid Valve Detachment Efficiency for Ventricular Septal Defect Closure: A Retrospective Comparative Study - Acta Cardiol Sin 2020;36:360_366 - doi:10.6515/ACS.202007_36(4).20191012A6.Sasson L, Katz MG, Ezri T, Tamir A, Herman A, Bove EL, Schachner A. Indications for tricuspid valve detachment in closure of ventricular septal defect in children. Ann Thorac Surg. 2006 Sep;82(3):958-63; discussion 963. doi: 10.1016/j.athoracsur.2006.03.094. PMID: 16928516.7.Основы экономики здравоохранения: учебное пособие / А.Р.Ильясова.– Казань: Изд-во Казанского университета, 2019. – стр. 15-168.Общественное здоровье и здравоохранение: национальное руководство / под ред. В.И. Стародубова, О.П. Щепина и др. – М.: ГЭОТАР-медиа, 2014. – 624 с.