CONGENITAL HEART DEFECTS: TETRAD OF FALLO (clinical case)

Congenital heart defects (CHDs) are the most common malformations. In children, in the structure of all malformations, CHD occurs in 30% of cases and is one of the most common causes of death in young children, and 5-8% of all CHD is Fallot's tetralogy.
According to the International Classification of Diseases of the 10th revision, there is Q 21.3 Tetralogy of Fallot - a ventricular septal defect with stenosis or atresia of the pulmonary artery, aortic extraposition, and right ventricular hypertrophy. The first reports of vice belong to M. Stensen (1673). A.A. Kisel (1887) was the first to carry out an intravital diagnosis of the defect. The French doctor Eyeppe-Louis Arthur Fallot (1888) introduced the term "tetralogy" (tetralogy) for the clinical designation of the four components of the "blue" disease. The clinic of Fallot's tetrad can be different, due to the variability of hemodynamic disorders. The severity of hemodynamic disorders and the severity of the defect are primarily determined by the degree of narrowing of the pulmonary artery, which can range from slight stenosis to complete atresia. The tetrad of Fallot is characterized by a high large ventricular septal defect (perimembranous subaortic) and aortic extraposition, that is, the displacement of the aortic orifice to the right so that it “sits astride” the interventricular septum, and from the right ventricle there is a direct exit into the aortic lumen. Thus, two blood streams enter the aorta - from the right ventricle (venous) and the left ventricle (arterial). The fourth sign of defect is right ventricular hypertrophy, which is a secondary compensatory component. The condition of a child with Fallot's tetrad progresses each time without surgical correction. Currently, there is a global trend of early surgical treatment. Pediatric cardiac surgeons talk about the need to operate during the first year of life. In our study, we want to talk about the importance of this operation in the first year of life.

1. Saperova E.V., Vahlova I.V. Vrozhdennye poroki serdca u detej: rasprostranennost', faktory riska, smertnost'. Voprosy sovremennoj pediatrii.

2. Krasuski R.A., Bashore T.M. Congenital heart disease epidemiology in the United States: blindly feeling for the charging elephant. Circulation. 2016;134(2):110-113. doi: 10.1161/ CIRCULATIONAHA.116.023370.

3. Kalashnikova E.A., Nikitina N.A. Rannjaja neonatal'naja, postnatal'naja diagnostika, klinicheskaja manifestacija, lechenie i prognoz. «Zdorov'e rebenka», 2015, №3(63), str. 52-55.

4. I.G. Lebed', O.N. Krjuchkova, E.I. Lebed', Ju.A. Lutaj. Tetrada Fallo: transformacija okazanija kardiologicheskoj pomoshhi ot rebenka k vzroslomu / Krymskij terapevticheskij zhurnal, 2014, №2, str.21-24.

5. Mozaffarian D., Benjamin E.J., Go A.S., et al. Heart Disease and Stroke Statistics-2016 Update: a report from the American Heart Association. Circulation. 2016;133(4):e38-360. doi: 10.1161/ CIR.0000000000000350.

6. Eurocat-network.eu [Internet]. Cases and prevalence (per 10,000 births) for all full member registries from 2010 to 2014 [cited 2017 Apr 19]. Available from:http://w w w . e u r o c a t - n e t w o r k . e u / a c c e s s p r e v a l e n c e d a t a /prevalencetables 2017; 16 (2): 126-133. doi: 10.15690/vsp. v16i2.1713). 6. Kardiologija detskogo vozrasta / Pod red. Caregorodceva A.D., Belozerova Ju.M., Bregel' L.V. — M.: GJeOTARMedia; 2014. — 784 s.

7. Marelli A.J., Mackie A.S., Ionescu-Ittu R. Et.al. Congenital heart disease in the general population: changing prevalence and age distribution. Circulation. 2007;115(2):163-172. doi: 10.1161/ CIRCULATI0NAHA.106.627224.

8. Klinicheskie rekomendacii po vedeniju detej s vrozhdennymi porokami serdca / Pod red. Bokerija L.A. - M.: NCSSH im.A.N. Bakuleva; 2014. - 342 s.

9. K.S. Kemel'bekov, U.A. Kozhahmetova, Sh. K. Kosymbetova, A.E. Kuzenbaeva. — Tekst: neposredstvennyj // Molodoj uchenyj. — 2020. — № 2 (292). — S. 59-62. — URL: https://moluch.ru/archive/292/66254/ (data obrashhenija: 21.06.2022).

10. Shabalov_n_p_detskie_bolezni_v_2-1.pdf.