Стентування відкритої протоки як перший етап хірургічного лікування тетради Фалло з незливними гілками легеневої артерії

Abstract

The aim – to show the results of patent ductus arteriosus (PDA) stenting as the first stage of palliative treatment in patients with tetralogy of Fallot with non-confluent branches of the pulmonary artery.Materials and methods. This retrospective, single-center study included 10 consecutive patients who underwent PDA stenting since 2013 to 2023. The average age at the time of surgery was 96.00 ± 82.92 days (range 4 to 411 days), the average weight was 5.10 ± 1.78 kg (range 2.8 to 11 kg). The arterial oxygen saturation level (SaO2) before the intervention was 72.0 ± 6.7 % (range 60 to 87 %).Results. There were no intraoperative complications in all patients of this group. The length of the stay in the intensive care unit after surgery was 5.00 ± 1.36 days. SaO2 level increased to 89.00 ± 4.08 %. The duration of artificial lung ventilation after surgery was 36.5 ± 18.00 hours, and the duration of inotropic support was 81.1 ± 33.8 hours. In the long term, all patients showed significant growth of the native pulmonary artery branches. All patients of this group achieved total repair of this pathology after 192.00 ± 60.28 days, on average. At the moment of total repair, the size of the left branch of the pulmonary artery increased from 3.9 ± 0.8 mm to 7.8 ± 1.6 mm, and the right branch increased from 5.8 ± 1.2 mm to 7.70 ± 1.04 mm; the Nakata index increased from 133.0 ± 29.1 mm2/m2 to 241.2 ± 97.8 mm2/m2; end-diastolic index of the left ventricle increased from 31.4 ± 10.8 ml/m2 to 43.1 ± 11.4 ml/m2.Conclusion. PDA stenting in patients with tetralogy of Fallot combined with non-confluent branches of the pulmonary artery is an effective palliative procedure. This method allows to postpone the total repair to an older age, ensures sufficient and symmetric growth of the branches of pulmonary artery, and helps to avoid risks associated with repeat open heart surgeries.