Dovgaliuk A. Balloon dilatation of pulmonary artery stenosis as a new approach to staging treatment Tetralogy of Fallot

The thesis is the first work in Ukraine, which highlights the experience of optimizing pulmonary blood flow with endovascular method in children with tetralogy of Fallot as an alternative to systemic to pulmonary anastomosis. The work deals with the problem to improve the results of surgical treatment of patients with tetralogy of Fallot by improving and implementing of balloon pulmonary valvuloplasty. The analysis of results of the optimization of pulmonary blood flow performed in 161 patients. The effect of balloon pulmonary valvuloplasty on hemodynamic, growth of branches pulmonary arteries, pulmonary valves and the left ventricle was investigated. First designed and substantiated indications and contraindications to optimize pulmonary blood flow in Tetralogy of Fallot with method. The protocols of implementation endovascular techniques, protocols of anesthesia, protocols of postoperative patient management were improved and implemented. The scientifically based diagnostic and therapeutic algorithm in the different form of Tetralogy of Fallot was developed. Introduction of the result of the study allowed: to reduce mortality in stage treatment Tetralogy of Fallot with 7.7% to 0%; to reduce the incidence of early re-interventions after balloon pulmonary valvuloplasty from 4.2% to 0%; to increase the effectiveness of balloon pulmonary valvuloplasty from 82% to 98%.