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History of pediatric cardiac surgery

Аuthor: Аldanova Aziza

Editor: Аibulova Diana





       Currently, the birth of children with defects is one of the most relevant topics in medicine. However, we cannot separate and classify the most problematic type of Vice. Congenital heart defects (CHD) - a violation in the structure of the heart or large vessels, one of the most common birth defects. Consequently, it is the main cause of child mortality. Meanwhile, over the years, opportunities and conservative approaches have been developed in the treatment of cardiovascular diseases. In this article, you can learn about the history of pediatric cardiac surgery.


       In 1937, American surgeon John Strider performed the first operation to correct an open ductus arteriosus to a 22-year-old patient, but due to postoperative complications, the young patient died on day 4 from sepsis, since antibiotics were still unavailable at that time. A year later, in 1938, this procedure was repeated by gross E., a Boston surgeon. For the first time, he performed surgery on the most common of all malformations – the open ductus arteriosus. The above-mentioned surgeons were able to give an impetus to the development of surgery for CHD. With the advent of antibiotics, the development of cardiac surgery began in the 40s.


       So, in 1944, Helen Brooke Taussig, the founder of pediatric cardiology, an American doctor at Johns Hopkins hospital, together with her colleague Alfred Blelock, decided to perform the first operation to treat a severe birth defect like Fallot's tetrad (a defect consisting of a defect in the interventricular septum, narrowing of the right ventricular excretory tract, displacement of the aorta to the right and hypertrophy of the right ventricle) for a 15 - month-old girl. It is worth noting that in the beginning, Helen Taussig offered tgthto try this method to gross from the Boston hospital, but he refused this offer. Through trial and error, Helen and Alfred were soon able to determine the best method for treating Fallot's tetrad. In the same year, on October 29, Clarence Krafoord, a Swedish doctor, was able to perform a procedure to eliminate aortic coarctation (narrowing or complete closure of the aortic lumen) to a 12-year - old boy, also a 27-year-old farmer. In the same year, Alfred Blalock showed interest in this pathology, as soon as he was able to perform the first subclavian - aortic anastomosis to eliminate narrowing of the aortic lumen in a dog. This technique was so effective that in 1947 it was used by surgeon Clagett on a patient with chronic coarctation at the Mayo clinic. In October 1958, oke Sening, Professor of surgery at the University of Zurich, successfully performed an operation using his own method of "intra-atrial switching in TMS" for an 8-year-old boy with a transposition of the main arteries (TMS) and a large ventricular septal defect. After the procedure, the boy's cyanosis (blueness) disappeared, and his development and growth improved due to oxygen saturation. And in 1959, Sening published his technique in the journal “Surgery". And soon in the USSR in 1985 they were able to perform the operation Senning-a 7 - month-old child, the operation was successful, and the surgeon was Alexi-Meskhishvili V. Also, for 4 years since 1984, 75 such operations were successfully performed. However, with the advent of arterial switching in TMS, the Senning method took a back seat as an alternative method. It is also worth noting that not always the same method can be applied to all patients: everyone has an individual approach to treatment. For example, someone may have contraindications to arterial switching, which is replaced by hemodynamic correction.


       In 1953, American John Gibbon was the first surgeon to use an artificial blood circulation machine (AIC) and was able to perform an operation to repair a hole in the inner wall of the heart of an 18 - year-old girl, suspending her heart for 27 minutes. AIC was made in 1926 by scientists Bryukhonenko S. S. and Chechulin S. I. and soon was able to find application in all other procedures.


       Also, in 1964, mustard V. was able to perform the first operation to correct TMS, using the method of creating an “intra-atrial tunnel". Soon this method was chosen for the treatment of TMS defects. In those days, it was also difficult to find transplants to treat certain defects. For example, in 1962, with a defect in the aortic valve apparatus, Ross D. decided to replace it with a pulmonary artery valve. To this day, this Ross procedure is optimal, since it did not interfere with the growth and development of children and did not cause postoperative complications such as transplant rejection. And in 1981, heart surgeon Norwood.V. proposed his own method for correcting hypoplasia syndrome (underdevelopment of tissue) of the left heart, which he studied for 20 years. Currently, the procedure is considered one of the most complex and with a mortality rate of 10% to 30%.


      Over the years, generations of doctors and surgeons succeed each other, but their contribution to the development of cardiac surgery in the name of saving the lives of young children deserves a low bow. With the help of the proposed methods of treatment, many doctors have now been able to save the lives of millions of children. Knowing the history and having information about the past, we can be sure of our present.