Fedevych O. Arterial switch operation at the first hours of life in neonates with prenatally diagnosed transposition of great arteries

The thesis is devoted to a new surgical approach to the treatment of neonates with prenatally diagnosed transposition of great arteries (TGA) - arterial switch operation during the first hours of patient's life. Preoperatively, due to the peculiarities of transient hemodynamic of TGA, patients didn't request balloon atrioseptostomy and medication. Results of the 205 consecutive arterial switch operations in two groups of patients from December 2009 to December 2012 are presented. We analyzed and compared the immediate and mild-term results of the proposed and conventional surgical approach, evaluated the effectiveness of surgical interventions, identified risk factors that can impair the results of surgical treatment of TGA. Based on the identified predictors, we created the mathematical models of direct prediction of adverse clinical outcomes in neonates with TGA after arterial switch operation. This work is the first Ukrainian and international research that focuses at studying of hypoxic injury of myocardium and organs of newborns with TGA perioperatively, using immunobiological tests, histological and electron microscopic methods. Сomplex protocol of perinatal management of patients with TGA was implemented.