Boiko O. Pulmonary atresia with intact ventricular septum: diagnosis and indications for surgical treatment.

The thesis is devoted to the diagnosis and treatment of PA/IVS, studying anatomy and morphology of the defect. This paper comprehensively studied echocardiographic characteristics of defects, diagnostic criteria for correction measures. The integrated echocardiographic diagnosis method which allows to define accurate topical diagnosis of a defect is elaborated. We have developed an algorithm for diagnosis and treatment of PA/IVS. Indications and contraindications for the different methods of operative treatment (surgical and endovascular) are refined; algorithm for biventricular correction with morphological defects taken into account is suggested. The mathematical model predicting the way of correction (biventricular, one and half ventricular and single ventricular ways). In clinical material (76 infants with PA/IVS) the morphological features of defects are studied, the immediate and late results of correction, the reasons for the poor results, the risk factors of surgery are analyzed. The study optimized PA/IVS diagnosis system and treatment strategy. Practical recommendations are elaborated and implemented in the treatment process. It provided improvement of surgery outcomes and reduction of postoperative mortality from 20% to 15%.