Recommendations for determining optimal age for the treatment of congenital heart defects

Abstract

The article presents the analysis of congenital heart defects classifications from the practical point of view. A variant of our classification of congenital heart defects is presented with the rationale for optimal time of surgical correction. The scheme-classification allows predicting possible critical hemodynamic states in children with congenital heart defects and is used in the practice in the Republic of Tatarstan for more than 15 years. Organizational measures taken during the recent decades in the field of cardiac and vascular surgery according to goal-oriented programs of the Government of RF and Ministry of healthcare of RF under the direct control of the chief cardiac surgeon of the Ministry of healthcare of RF academician L.A. Bokeriya, resulted in significant improvement of the situation with this specialty in Russia. In particular, regarding treatment of congenital heart defects, the number of surgeries in RF (about 15 000 per year) exceeds the number of children born with congenital heart defects (12 000 to 13 000 per year). Thus, in the nearby future the surgery waiting list will be completed, and some time later the named numbers will become equal. In the Republic of Tatarstan the waiting list for the surgeries for congenital heart defects was completed in 2005 due to additional financing from the president M.Sh. Shaymiev, and since then all children with congenital heart defects are registered soon after birth and are operated on in the optimal time that determines the minimal risk of postsurgical complications and lethal outcomes.