Diagnostics
In order to identify pulmonary atresia, the following studies are prescribed:
- electrocardiography (the test provides information about the pathological condition of the right ventricle, etc.);
- chest x-ray (gives an idea of the specifics of the vascular pattern of the lungs);
- phonocardiography (allows you to register pathological noises);
- echocardiography (makes it possible to assess the structural disorder of one of the ventricles, as well as obtain data on the pathological blood flow);
- angiocardiographic study (makes it possible to study parts of the heart and large vessels);
- cardiac probing (during the study, the pressure in both ventricles, etc.) is determined.
Catalog
Cardiac surgeon, scientist, teacher and organizer of science, Doctor of Medical Sciences (1973), Professor (1982), Academician of the Russian Academy of Medical Sciences (1994), Academician of the Russian Academy of Sciences (2011), Honored Scientist of the Russian Federation (1994) , laureate of the Lenin Prize (1976), State Prize of the USSR (1986), State Prize of the Russian Federation (2002), Prize of the Government of the Russian Federation (2003).
In 1994, L.A. Bockeria was elected through a competition to the position of director of the National Research Center for Agricultural Sciences named after. A.N. Bakuleva. In 1998, he simultaneously became director of the Center for Surgical and Interventional Arrhythmology of the Ministry of Health of the Russian Federation.
Since 1994, he has been the head of the Department of Cardiovascular Surgery at the Russian Medical Academy of Postgraduate Education (RMAPO) of the Ministry of Health of the Russian Federation. Since 1995, he has been the head of the Department of Cardiovascular Surgery No. 2 of the Moscow Medical Academy (now the First Moscow State Medical University), which he created. THEM. Sechenov Ministry of Health of the Russian Federation.
Since 2003, he has headed the Department of Cardiovascular Surgery and Interventional Cardiology at the Moscow State Medical and Dental University. A.I. Evdokimov Ministry of Health of the Russian Federation.
On the initiative of L.A. Bokeria at the National Medical Research Center for Agricultural Sciences successfully operates an educational and research center that annually conducts 4–6 courses of postgraduate advanced training for senior specialists.
L.A. Bokeria performs the entire known arsenal of heart surgeries for a wide variety of pathologies: from 3 to 6 operations per day, that is, from 700 to 900 operations using artificial circulation per year.
Since 1996, he has been the chief cardiac surgeon of the Ministry of Health of the Russian Federation.
L.A. Bockeria is the author and co-author of over 3,700 scientific publications, including more than 250 books, more than 100 inventions and utility models, more than 300 computer programs and databases, a number of which are registered abroad, on various problems of cardiovascular surgery, cardiology, medicine education and organization of medical science.
L.A. Bockeria owns unique works on the theoretical substantiation and clinical use of the hyperbaric oxygenation method in heart and vascular surgery. He is a leading specialist in the field of diagnosis and surgical treatment of cardiac rhythm and conduction disorders (especially tachyarrhythmias), including various combinations of cardiac arrhythmias with congenital and acquired heart defects and anomalies, coronary disease.
L.A. Bokeria is the initiator of the development of another new section of cardiac surgery in our country - minimally invasive heart surgery. L.A. made a great contribution. Bockeria in solving the problem of surgical treatment of coronary artery disease.
The role of L.A. is great. Bockeria in the development of new approaches to surgical treatment of terminal heart failure. His merit is the development of new operations in a severe category of cardiac surgical patients with various forms of cardiomyopathies. He was the first to develop the concept of dynamic cardiomyoplasty, including in children. L.A. Bockeria performed the first implantation of an artificial heart ventricle in our country and, after a long break, initiated the resumption of heart transplant operations at the Center.
On the initiative of L.A. Boqueria introduced advanced technologies for diagnosis and reconstructive surgery of diseases of the ascending aorta and arch into clinical practice.
He generated the development of another direction of modern medical science - creative cardiology, which determines the need for creative cooperation between doctors of different specialties: cardiologists, cardiac surgeons, specialists in functional diagnostics, fundamental and applied disciplines.
Under the leadership of L.A. At the Boqueria Center, new high-tech principles for the prevention and treatment of patients with cardiovascular pathology are being developed and introduced into clinical practice - the use of gene and cell therapy methods.
Academician L.A. Boqueria is conducting priority research on the creation of bioprosthetic heart valves for the correction of valve defects - a low-profile, curved bioprosthesis of the mitral and tricuspid valves, reproducing the natural shape of the fibrous ring, on an elastic frame. The study of the effectiveness of myocardial protection in children of the first year of life with the use of the new intracellular cardioplegic solution “Bokeria-Boldyreva”, created at the National Medical Research Center for Cardiovascular Surgery under the leadership of L.A., continued. Boqueria.
L.A. Boqueria is actively involved in the methodology of medical science and teaching activities. He is the founder of the country's largest cardiac surgery school, having trained more than one generation of doctors - cardiac surgeons, cardiologists, resuscitators and specialists in other related specialties.
L.A. Bockeria is the scientific supervisor of 350 candidate dissertations and a consultant of more than 100 doctoral dissertations. He is the founder of the publishing house NMITSSSH named after. A.N. Bakuleva with the printing house, founder and editor-in-chief of the journals “Annals of Surgery”, “Bulletin of the National Medical Center for Cardiovascular Surgery named after. A.N. Bakulev “Cardiovascular diseases”, “Childhood diseases of the heart and blood vessels”, “Clinical physiology of blood circulation”, “Annals of Ari, information collection “Cardiovascular surgery”; Editor-in-chief of the journal "Thoracic and Cardiovascular Surgery".
Active work of L.A. Boqueria and his contribution to domestic healthcare have been awarded titles and awards of the highest value. He is a laureate of the Lenin Prize (1976), two State Prizes (1986 - USSR, 2002 - Russian Federation), and the Prize of the Government of the Russian Federation (2003). For outstanding achievements of L.A. Bockeria was awarded the Order of Merit for the Fatherland, III (1999), II (2004) and IV (2010) degrees, the Order of Dignity and Honor (Republic of Georgia, 1999), the Order of St. Sergius of Radonezh, II degree (2001). The Russian Biographical Institute has repeatedly recognized L.A. Bokeria “Person of the Year”, and in 2000 - “Person of the Decade” in the “Medicine” category. In 2002, he was awarded the title “Legend Man”, the all-Russian “Russian National Olympus” award, established by the Government, the Union of Industrialists and the Third Millennium Foundation. As one of the leading cardiac surgeons in the world in 2003, L.A. Bokeria was awarded the international Golden Hippocrates award. In 2004, he was awarded the RAS Triumph Prize in the Life Science – Medicine category. In 2004, he was awarded the Order of Patron, which is awarded by the Patrons of the Century Charitable Foundation for his outstanding contribution to the revival and prosperity of the world, for the greatness of the soul, for selfless generosity; in 2004 and 2005 – the Golden Badge of Honor “Public Recognition”, which is awarded by the National Foundation for “Public Recognition”, the National Civil Committee for Interaction with Law Enforcement, Legislative and Judicial Bodies and the independent organization “Civil Society” for great personal contribution to the development of the domestic medicine, conducting unique cardiac surgery using the latest medical technologies that saved the lives of hundreds of children and newborns, many years of fruitful scientific, practical, pedagogical and educational activities, active citizenship.
In 2006, L.A. Boqueria was awarded the Honorary Diamond Order “Public Recognition”, awarded a diploma from the Presidium of the Parliament of the Peoples of Russia “for saving numerous lives, outstanding knowledge, ability to lead, for unique personal qualities - nobility, courage, sense of duty, ability to preserve honor and dignity, keep one’s word and do business, also for faith in the great future of the Fatherland,” a Gold Medal for outstanding contribution to the education of Russia and a Gold Star “Honor, Pride and Glory of Russia.”
In 2008, L.A. Bockeria was awarded the medal “For practical contribution to strengthening the health of the nation”, the Order of Honor with the title “Support of Honest Business” and the honorary title “Outstanding Cardiac Surgeon of Our Time”. In 2009, the huge contribution of L.A. Bockeria's contribution to science and domestic healthcare was awarded the A.N. Prize. Kosygin “For great achievements in solving problems of the development of the Russian economy” and the Moscow City Prize in the field of medicine “for the development and introduction into clinical practice of a new biological valve “Bioglis”.
L.A. Bokeria is a full member of the American Association of Thoracic Surgeons (1991), member of the board (1992) and member of the Presidium (since 2003, consul) of the European Society of Thoracic and Cardiovascular Surgeons, member of the board of the European Society of Cardiovascular Surgeons, member of the scientific board of the International Cardiothoracic Center of Monaco (1992), member of the Serbian Academy of Sciences (1997), honorary member of the American College of Surgeons (1998), academician of the Academy of Medical Sciences of Ukraine, honorary professor of Moscow State University. M.V. Lomonosov (2011), foreign member of the National Academy of Sciences of Georgia (2012).
He is the president of the Association of Cardiovascular Surgeons of Russia (1995), president of the All-Russian public organization “League of National Health” (2003), member of the Public Chamber of the Russian Federation of all convocations.
Treatment
The choice of treatment for pulmonary atresia is directly related to the specific characteristics of the right ventricle and pulmonary artery. The most effective is surgical treatment.
- Drug treatment (does not eliminate the problem, usually prescribed before surgical treatment).
- Surgical treatment (often carried out in several stages, each of which is carried out at certain intervals):
- endovascular operations (a balloon catheter is inserted through the femoral artery to the site of narrowing of the channel through which blood leaves the right ventricle; its inflation leads to improved hemodynamics);
- open heart surgery (during the operation, a connection is established between the right ventricle and the pulmonary artery).
Pulmonary atresia: causes
Pulmonary atresia is one of the most complex and dangerous heart diseases. The frequency of this pathology is approximately 7 cases per 100 thousand newborns. Among all congenital heart pathologies, the disease accounts for 1-3%.
The formation of the defect occurs when there is an abnormal fusion of the endocardial ridges, which are the rudiments of the semilunar valves. In the future, this can cause fusion of the pulmonary artery.
The etiology of the disease is still unclear. According to one assumption, unfavorable factors affecting a woman’s body during pregnancy play a certain role, as a result of which embryogenesis is disrupted. For example, a pregnant woman's use of hormonal medications and antibiotics, smoking, or drinking alcohol and drugs can have a negative impact on the development of the fetal cardiac system.
During the antenatal period, the release of blood into the trunk of the pulmonary artery from the right ventricle is sharply disrupted, which is caused by the fusion of the pulmonary valve flaps. As a result, the pressure in the right ventricle increases, the filling of the embryonic sinusoidal-coronary messages of the right ventricle increases. Blood can escape from there only in case of triscupid insufficiency. This insufficiency is the cause of a significant increase in the size of the right atrium.
