vtioВестник трансплантологии и искусственных органовRussian Journal of Transplantology and Artificial Organs1995-1191Academician V.I.Shumakov National Medical Research Center of Transplantology and Artificial Organs", Ministry of Health of the Russian Federation10.15825/1995-1191-2024-1-67-77vtio-1699Research ArticleТрансплантация сердца и вспомогательное кровообращениеHeart Transplantation and Assisted CirculationПервый опыт имплантации искусственного желудочка сердца HeartMate III у детей после хирургической коррекции сложных врожденных пороков сердцаImplantation of HeartMate III ventricular assist devices in children after surgical treatment of complex congenital heart defect: first experienceШаталовК. В.ShatalovK. V.

121552, Москва, Рублевское шоссе, 135

135, Rublevskoe Shosse, 121552, Moscow

МахалинМ. В.MakhalinM. V.

121552, Москва, Рублевское шоссе, 135

135, Rublevskoe Shosse, 121552, Moscow

mmaxalin@mail.ruЧупинаМ. А.ChupinaM. A.

121552, Москва, Рублевское шоссе, 135

135, Rublevskoe Shosse, 121552, Moscow

ГолуховаЕ. З.GoluhovaE. Z.

121552, Москва, Рублевское шоссе, 135

135, Rublevskoe Shosse, 121552, Moscow

ФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии имени А.Н. Бакулева» Минздрава РоссииРоссияBakulev Center for Cardiovascular SurgeryRussian Federation2024131120232616777Copyright © Шаталов К.В., Махалин М.В., Чупина М.А., Голухова Е.З., 20242024Шаталов К.В., Махалин М.В., Чупина М.А., Голухова Е.З.Shatalov K.V., Makhalin M.V., Chupina M.A., Goluhova E.Z.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.transpl.ru/vtio/article/view/1699

Актуальность. Достаточно велико количество пациентов с критической сердечной недостаточностью, перенесших хирургическую коррекцию сложных врожденных пороков сердца. Имплантация систем механической поддержки кровообращения является единственной возможностью лечения пациентов с терминальной сердечной недостаточностью, рефрактерной к медикаментозной терапии. Опытом имплантации искусственных желудочков сердца маленьким пациентам обладает всего несколько центров, что представляет большую проблему для современной детской кардиохирургии. Цель исследования: представить первый опыт имплантации искусственного желудочка сердца (ИЖС) HeartMate III у пациентов после хирургической коррекции сложных врожденных пороков сердца. Материалы и методы. В 2021–2022 годах в ФГБУ «НМИЦ ССХ им. А.Н. Бакулева» Минздрава России было имплантировано 4 системы HeartMate III детям с критической сердечной недостаточностью, ранее оперируемых по поводу сложных врожденных пороков сердца. В одном случае одномоментно с имплантацией ИЖС было выполнено репротезирование аортального клапана. Результаты. Все пациенты были выписаны из клиники. У одного пациента интраоперационно развилась правожелудочковая недостаточность, что потребовало применения правожелудочкового обхода в течение 8 суток. Осложнений со стороны центральной нервной системы, кровотечения, тромбоза насоса, инфекции не отмечалось. Заключение. Имплантации искусственного желудочка сердца (ИЖС) HeartMate III возможна для пациента с массой тела от 21 кг и BSA от 0,88 м2 . У детей повышается толерантность к физической нагрузке, они полностью социально адаптируются, могут посещать школьные учреждения.

Background. There is quite a high number of patients with advanced heart failure (HF) who have undergone surgical treatment for complex congenital heart defects. Implantation of mechanical circulatory support systems is the only treatment option for patients with refractory end-stage heart failure. Only a few centers have experience in implantation of ventricular assist devices (VAD) in children, which is a major challenge for modern pediatric cardiac surgery. Objective: to present our first experience of implantation of HeartMate III VADs in patients after surgical correction of complex congenital heart defects. Materials and methods. From 2021 to 2022, at Bakulev Center for Cardiovascular Surgery, four HeartMate III systems were implanted in children with advanced HF, who had previously undergone surgery for a complex congenital heart defect. In one case, aortic valve implantation was carried out simultaneously with VAD implantation. Results. All patients were discharged from the center. One patient developed right-sided heart failure intraoperatively, which required the use of a right ventricular assist device (RVAD) for 8 days. There were no complications from the central nervous system, bleeding, pump thrombosis, or infection. Conclusion. HeartMate III can be implanted in patients with body weight ≥21 kg and BSA ≥0.88 m2 . Children’s tolerance to physical activity increases, they are fully adapted socially, and can attend school.

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The authors declare that there are no conflicts of interest present.