Тетрада Фалло – «Старый» порок в XXI веке – нерешенные вопросы этапной хирургической коррекции

П.Ф. Черноглаз
ГУ «РНПЦ детской хирургии», г. Минск
Несмотря на то, что порок известен давно, разработаны методы хирургической коррекции, позволяющие достичь прекрасных непосредственных и отдаленных результатов, до сих пор до конца не решены тактические вопросы этапной коррекции порока в ситуациях, когда первичная радикальная коррекция невозможна в силу таких причинкак тяжелое исходное состояние, малый вес пациента, недоразвитие ветвей легочной артерии (ЛА). Помимо классических межсистемных анастомозов по Блелок-Тауссиг в клиническую практику внедряются такие эндоваскулярные методики поддержания легочного кровотока как стентирование выносящего тракта правого желудочка (ВТПЖ) и стентирование открытого артериального протока (ОАП). Данные методики при всех преимуществах миниинвазивных технологий в определенных клинических и анатомических ситуациях не уступают, а в большинстве случаев превосходят классические хирургические методики.
ключевые слова: врожденный порок сердца, тетрада Фалло, открытый артериальный проток, стентирование, анастомоз по Блелок-Тауссиг

для цитирования: П.Ф. Черноглаз. Тетрада Фалло – «Старый» порок в XXI веке – нерешенные вопросы этапной хирургической коррекции Неотложная кардиология и кардиоваскулярные риски, 2021, Т. 5, № 1, С. 1210–1216.

Tetralogy of Fallot – «Old» congenital heart defect in the xxi century – unresolved questions of stage-by-stage surgical correction
P.F. Charnahlaz
Despite the fact that the defect has been known for a long time and methods of surgical correction have been developed that allow achieving excellent immediate and long-term results, the tactical issues of stage-by-stage correction of the defect in situations where primary radical correction is impossible due to such reasons as a severe initial condition, low weight of the patient, underdevelopment of the branches of the pulmonary artery (PA) have not yet been fully resolved. In addition to classical Blalock-Taussig intersystem anastomoses, such endovascular techniques of maintaining pulmonary blood flow as stenting of the right ventricular outflow tract (RVOT) and stenting of the patent ductus arteriosus (PDA) are being introduced into clinical practice. These techniques, with all the advantages of minimally invasive technologies in certain clinical and anatomical situations, are not inferior, and in most cases surpass classical surgical techniques.
keywords: tetralogy of Fallot, patent ductus arteriosus, stenting, congenital heart defect, Blalock-Taussig shunt

for references: P.F. Charnahlaz. Tetralogy of Fallot – «Old» congenital heart defect in the XXI century – unresolved questions of stage-by-stage surgical correction. Neotlozhnaya kardiologiya i kardiovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2021, vol. 5, no. 1, pp. 1210–1216.

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