Ivanov Y. Surgical repair for truncus arteriosus

The all aspects of truncus artriosus repair were analysed in this dissertation. This is the first study in Ukraine that devoted to the problem of truncus artriosus repair. Preoperatively, it was revealed that including genetic examination as well as CT scan are beneficial in preoperative examination for patients with common arterial trunk. Many changes were happened in surgical strategy for truncus arteriosus repair during this study. Intraoperatively, it was found that using direct connection as the approach for right ventricular outflow tract reconstruction was associated significantly with high hospital mortality. Another finding was that using handmade conduit polytetrafluorethylene with three polytetrafluorethylene cusps for right ventricular outflow tract reconstruction leads to noticeable hospital mortality decrease. It was proved that cardioplegic solution Custodiol is better for cardioplegia in patients with truncus arteriosus than cardioplegic solution prepared ex tempore. The role of learning curve in truncus arteriosus repair was also recognized by analyzing hospital mortality causes. Additionally, risk factors for hospital mortality were identified. It was revealed that patients could benefited from low-dose dopamine administration along with levosimendan while they stay in intensive care unit. The risk factors for truncal valve reintervention were identified. Freedom from right ventricular outflow reintervention was calculated in long-term follow up. As a result, the hospital mortality decreased significantly to 3.6 % in 2008-2012 years compared with 45.2 % in 1997-2007 years.