Результаты применения ресинхронизирующей терапии для лечения сердечной недостаточности у детей и лиц молодого возраста в нцссх им. А. Н. Бакулева РАМН

The results of completed studies, dedicated to application of cardiac resynchronization in adults can`t be completely extrapolated on patients of childish and adolescent age, due to a great variety of congenital pathology of cardiovascular system, including systemic right ventricular failure and failure of single ventricle and also of age-related heterogeneity. There is definite experience in child treatment with heart failure with resynchronized therapy technique in A. N. Bakoulev scientific center for cardiovascular surgery, RAMS, based on department of surgical treatment of interactive pathology (scientific advisor academician L. A. Bockeria, RAMS). Obtained results could show the effectiveness of resynchronized therapy in children with heart failure. The goal of this study is to analyze the results of practical use of resynchronized therapy for heart failure treatment in children and young patients in A. N. Bakoulev scientific center for cardiovascular surgery, RAMS. Material and Methods. The retrospective analysis of application of cardiac resynchronization in heart failure in 6 children and young patients (3 female patients and 3 male patients) was performed. The mean age of patients was 8.83±8.64 years (from 2.4 to 24.1 years). The mean follow-up period of long-term results was 10.63±3.02 months. Results. The performed analysis proved the effectiveness of heart failure treatment in children using resynchronized therapy technique: ejection fraction (EF) of left ventricle significantly increased from 29.0±11.8 to 37.2±11.6% (p=0.0277); end systolic volume (ESV) of left ventricle significantly decreased from 155.2±90.2 to 112.7±64.3 ml (p=0.0277); end diastolic volume (EDV) of left ventricle significantly decreased from 238.7±149.6 to 171.7±94.3 ml (p=0.0277); interventricular mechanical delay (IVMD) according to sphygmic Doppler sonography data significantly decreased from 42.7±24.9 to 12.8±20.6 ms (p=0.0431); intraventricular mechanical delay (IVMD), measured in M-mode, significantly decreased from 210.8±72.7 to 61.5±57.0 ms (p=0.0277); peak rate of pressure rise in left ventricle significantly increased from 345.7±144.2 to 749.0±70.7 mm Hg (p=0.0277). Conclusions. To date, resynchronized therapy is becoming an effective and promising treatment method of heart failure and for myocardium management in children and young patients. The study of such aspects as development of clear criteria in patients` selection, development of conducting technique of this implantation system procedure for cardiac resynchronized therapy, data bank formation about treated patients for following detailed analysis, planning and conduction of retrospective randomized studies of this method application in children is actual now.