Golovenko O. Surgical treatment of ventricular septal defect with high pulmonary arterial hypertension

The research is dedicated to the surgical treatment of patients with ventricular septal defect (VSD) and severe pulmonary arterial hypertension (PAH). For the first time in Ukraine presented a practical solution to the actual scientific task - define the criteria for operability of patients with VSD and severe PAH, as well as the development and implementation of an effective method of surgical treatment of this pathology. Analysis of VSD repairs is allowed to define the indications and contraindications for surgical treatment, especially using a modified method of VSD repair. The studies allowed identifying predictors of hospital mortality and mortality and occurrence of postoperative severe PAH in terms of late follow-up. It is shown that VSD repair in patients with severe PAH was associated with good immediate and long-term results and was an effective surgical treatment for such patients in cases, when it is indicated. The algorithm of choice of surgical treatment with indications for VSD repair in patients with severe PAH based on catheterization data was developed and provided in clinical practice. Development and implementation of a modified method of VSD repair allowed to reduce hospital mortality from 10.8% to 2.5%, effectively prevent the development of acute RV failure in the early postoperative period and left opened right to left shunt in some patients with persistent severe PAH. A calculated mathematical model for patients with VSD and severe PAH based on diagnostic data, which allows to predict the risk of negative results of surgical treatment.