1. Congenital vices of the heart

2. Prevalence
Congenital heart diseases are the result of abnormal intrauterine development of cardiovascular system of child.
Frequency of congenital heart failure is 0.5% of all newborn children and 0.2% of all children after 2 years old.
Almost 50% of newborns die within the first month of life without medical treatment, 25% die within 1 year.
About 20-35% of all congenital failures are uncyanotic , because skin is normal colour.
Nowadays there are 100 types of congenital failures.

3. Defect of interatrial wall
Frequency 6-10% of all congenital failures
Modern cardiosurgery begins from operative closure of Defect of interatrial wall on empty (1952) and opened (1953) heart.

4. Defect of intervenrticle wall
Frequency 20% of all congenital failures
Primary was studied by Roger in 1879.

5. Fallo’s tetrad Frequency 5-7% of all congenital failures
Primary was studied by French doctor Etienne-Louis Arthur Fallot in 1888.
But surgical correction was performed only in 1945 by Alfred Blalock (palliative operation).
First general operation was performed by Lellihei on 30 april at 10-monthly child.

6. Transposition of main arteries
Frequency 4-10% of all congenital failures
Both at boys and girls.
In Blalock и Hanlon had done Atrioseptotomy.
In Jatene offered surgical anatomical correction of this failure, which is main method till the present time.

7. First heart operation in Uzbekistan was performed by V. V
First heart operation in Uzbekistan was performed by V.V. Vakhidov in 1960

8. History of problem
In October 1975 was founded department of heart surgery headed by Darvin Sadikovich Gulyamov. It consists from 2 parts: surgery of congenital and acquired heart failures. This way there was founded heart surgery in Uzbekistan.

9. Classification of the CVH
The first group — the vices of the heart with the intracardiac pathologic connections, conditioned the unset of the arterial blood into the venous riverbed (from the left to the right, primary pallor) — defect of the intraventricle septum, open arterial duct, aorto-pulponary fistula, mitral stenosis with the defect of the intraatrial septum.
The second group — the vices with the intracardiac pathologic connections, conditioned the unset of the venous blood into the arterial riverbed (from the right to the left, primary blue) — Fallo’s triad, tetrad and pentad, atresy of the tricuspid valve to the side of the right ventricle with the defect of the intraatrial septum, transposition of the main vessels.
The third group — innate vices of the heart, at which the defeats of the blood circulation created with the narrowing of the main vessels of the heart: isolated stenosis of the pulmonary artery, stenosis of the aorta’s mouth, coarctation of the aorta.

10. CVH
Fallo’s tetrad
Cardiac hunch

11. Special methods of research
echocardiography
X-ray CT
NMT
Probing of the cardiac cavities
angiocardiography

12. Methods of research
Isotope diagnostic
Echocardiography

13. Catheters for probing of the heart

14. Probing of the right parts of the heart
Angiocardiography

15. Left ventriculography

16. Left ventriculography

17. Aortography
Open arterial duct

18. Open arterial duct fast weakness
shortness of breath, increasing at the effort
heartbeat
reducing in the physical development
frequently pneumonias
pallor skin
cyanosis of the lower half of the body
at the exerting

19. Bandaging of the Botall’s duct

20. Sewing of the Botall’s duct with the SLR

21. Catheters for the embolization of the Botall’s duct

22. Embolization of the OAD

23. intraventricle septum
Defect of the
intraventricle septum

24. Defect of the intraventricle septum
shortness of breath
pallor skin
Increased liver
hypotrophy
reducing in the physical development
Deformation of the chest (cardiac hump)
Rough systolic noise at the III i/s
to the left from the sternum

25. The patch is putted to the defect’s area
Defect of the intraventricle septum
The patch is putted to the defect’s area

26. Occluder of the transcatheter system (Amplatzer) for closing of the defects of the septum

27. Fallo’s tetrad Narrowing of the pulmonary artery,
High defect of the intraventricular septum,
Dislocation of the aorta to the right and location of its mouth above the defect of the intraventricular septum
Hypertrophy of the right ventricule’s wall

28. Fallo’s tetrad Constant cyanosis of the skin
Short breathing-cyanotic attacks
Short breathing
Tachycardia
Sharp weakness
Loss of the consciousness
Finger as the “drum sticks”
reducing physical developement

29. Fallo’s tetrad

30. Fallo’s tetrad

31. Subclavian-pulmonary (Blelock-Tausig’s operation)
anastomosis
(Blelock-Tausig’s operation)

32. Putting of the patch to the defect of the
intraventricle septum at the Fallo’s tetrad

33. Coarctation of the aorta
headaches
Increasing blood pressure at hands
Petulance
Gravity and sensitivity of pulsation in a head
Nose bleedings
Deterioration of the memory and vision
Pain in the cardiac area
heartbeat
Heart defeats
Sometimes short breathing

34. Aorta’s coartation