An ambulance brought the baby to Lviv, the girl was no longer breathing on her own. Cardiac surgeons at St. Nicholas Hospital saved a child with critical aortic stenosis by performing a Ross-Connot operation. This is one of the most difficult heart interventions in babies. Such operations have not yet been performed in Lviv.
The patient is little Marichka from Transcarpathia. Her 24-year-old mother was preparing to be discharged from the maternity hospital in Mukachevo. But on the third day, during the examination, the doctors heard a murmur in the child’s heart. Next comes resuscitation and a difficult journey to Lviv. Without the ventilator, the girl simply would not have made it.
A team of pediatric cardiac surgeons was waiting for the girl at St. Nicholas Hospital. After an urgent examination, the doctors found that the ejection fraction, that is, an indicator of the efficiency of the heart muscle, is 16%, compared to the normal range of 60-70%. It was necessary to operate immediately.
Critical aortic stenosis occurs in only 3% of all children born with defects and is manifested by deformation of the leaflets and narrowing of the opening of the valve located between the aorta – the main artery departing from the heart – and the left ventricle, in which the great circle of blood circulation begins. That is why the girl’s blood did not flow well from the left ventricle to the ascending aorta. In addition, the valve opening was so small that the left ventricle had difficulty contracting and began to fail.
Specialists decided to operate in two stages. At first, the doctors stabilized the function of the left ventricle by the method of balloon valvuloplasty of the valve. In simple words, through a small puncture of the artery on the leg, a catheter with a spray bottle was introduced. So doctors expanded the aortic valve.
Immediately after the intervention, the fraction of the left ventricle recovered to 35-40%. However, the child was still on a ventilator. The opening of the heart valve was too small, so the girl could not breathe on her own. In order to save the child, doctors decided to perform a surgically extremely difficult Ross-Connot operation.
Doctors replaced the aortic valve with her own pulmonary artery valve. Then the zone under the aortic valve was expanded and the coronary arteries were reimplanted in the already new aortic valve. And in place of the pulmonary valve, an artificial vascular prosthesis with a valve inside was sewn. The operation lasted more than 7 hours.
The postoperative period passed without complications. On the eighth day, Marichka was disconnected from the ventilator, and a week later, she was transferred from the intensive care unit to the ward of the pediatric cardiac surgery department. And on the 21st, they were discharged home. Everything is fine with the child.
Lviv cardiac surgeons saved a child with critical aortic stenosis