Rudenko K. Surgery treatment for multiple ventricular septal defects.

Dissertation is devoted to the anatomіcal, clinical and haemodynamical manifestations of complete form of atrioventricular septal defect (AVSD) and features of this combination with other congenital heart diseases. In this dissertation the features of morphometric and morphological changes are comprehensively researched in the heart of patients with this pathology, comparing them with normal anatomy, developed systematizational features of surgical anatomy of complete form of AVSD at it's different types. It's investigated, that the complete form of AVSD with varied genetical anomalies, particulary with the Down's syndrome. Diagnostic criteria of the anatomical pecularities above mentioned defect is placed by the following criteria: results of echocardiography, angiocardiography, morphological and morphometrical datas. Specified testimonies and contra-indications of different methods of surgical treatment of complete form of AVSD (radical correction, haemodynamical correction, two-staging treatment), taking into the count of anatomical features of the defect, following of the results of morphometrical researches, indexes of contractility function of myocardium, state of pulmonary vascular river-bed, haemodynamics etc. Using considerable clinical material, results of surgical treatment of complete form of AVSD is analyzed in detail, cause of the hospital mortality and unfavorable postoperative results. As a result of executed research, effective system of diagnostics, operative management and postoperative treatment of complete form of AVSD are optimized. The findings testify, that primary radical correction of complete form of AVSD is the most rational to perform in the first half-year of life.