Chornenka I. Surgical aortic valvuloplasty in neonates and infants with aortic stenosis.

The dissertation aimed to improve the results of surgical treatment of patients with aortic stenosis by improving the methods of surgical correction and optimization of treatment protocols. The work is the first domestic research to study and compare the immediate domestic research and long-term results of surgical and balloon valvuloplasty. The work is based on a study of 155 patients under the age of one year with isolated aortic stenosis, who were hospitalized in Government institution “The scientific-practical children`s cardiac center” The Ministry of Health of Ukraine during the period from January 2009 to December 2019. The protocol for the treatment of patients with AS was improved: balloon valvuloplasty was performed in patients with signs of decompensation: Δp LV-Ao peak ≥ 60 mm Hg; Δp LV-Ao mean ≥ 40-45 mm Hg; EF≤45%; concomitant comorbid condition, which increased the risk of surgical correction. Surgical valvuloplasty was performed in patients in a stable condition: Δp LV-Ao peak ≥ 60 mm Hg; Δp LV-Ao mean ≥ 40-45 mm Hg; EF> 45%. Thanks to improved indications, the number of reoperated patients has been significantly reduced. A new approach to the surgical treatment of aortic stenosis in children under one year of age was developed, which involves dissecting the pseudocommissura to the level of the aortic wall to increase the area of AV opening. As a result of detailed analysis of treatment methods, the high efficiency and safety of the surgical method was proved.