Кохлеарная имплантация у ребенка с синдромом гипоплазии левых отделов сердца:клинический случай

Relevance. The hypoplastic left-heart syndrome at congenital heart disease has frequency of 261 cases out of 10,000 newborns. Children with hypoplastic left-heart syndrome can have comorbid congenital anomalies and acquired diseases that require treatment and are associated with high mortality risk.Description of a clinical case. Female patient, 6 years 4 months, with the hypoplastic left-heart syndrome was admitted to our hospital with the diagnosis «Sensorineural hearing loss, speech delay» for performing of cochlear implantation. The council of physicians was convoked before the surgery to coordinate patient management. Members of surgical, anesthesiology, laboratory and instrumental examination departments were involved into preoperative assessment and planning due to the high level of surgical and anesthetic risk. The patient was dismissed from hospital on the 10th day after cochlear implantation. The patient has undergone the course of auditory-verbal therapy a month after. The child was dismissed wit state improvement.Conclusion. The example of successfully performed surgery in the patient with hypoplastic left-heart syndrome and such severe comorbid pathology as sensorineural hearing loss is presented. Complete physical examination of the child in preoperative period and adequate preparation for the surgery were the key factors for patient successful management and further rehabilitation.Обоснование.Синдром гипоплазии левых отделов сердца при врожденном пороке сердца отмечается с частотой 261 случай на 10 000 новорожденных. Дети с синдромом гипоплазии левых отделов сердца могут иметь сопутствующие врожденные аномалии и приобретенные заболевания, которые требуют лечения и ассоциированы с высоким риском смерти.Описание клинического случая. Пациентка в возрасте 6 лет 4 мес с синдромом гипоплазии левых отделов сердца поступила в стационар с диагнозом «Двусторонняя сенсоневральная тугоухость, задержка речевого развития» для проведения кохлеарной имплантации. Перед оперативным вмешательством был созван консилиум с целью согласования тактики ведения пациента. В связи с высоким операционно-анестезиологическим риском в предоперационную подготовку были вовлечены как члены хирургической и анестезиологической бригад, так и специалисты по лабораторным и инструментальным исследованиям. На 10-е сут после кохлеарной имплантации ребенок выписан из стационара. Через 1 мес пациентке проведен курс слухоречевой реабилитации. Ребенок с улучшением состояния выписан домой.Заключение. Продемонстрировано успешно проведенное хирургическое вмешательство пациентке с синдромом гипоплазии левых отделов сердца и тяжелой сопутствующей патологией — двусторонней сенсоневральной тугоухостью. Комплексное обследование ребенка до операции, а также адекватно проведенная подготовка были залогом успешного лечения и последующей реабилитации пациента

Cochlear Implantation in a Child With Hypoplastic Left-heart Syndrome: Clinical Case

Relevance. The hypoplastic left-heart syndrome at congenital heart disease has frequency of 261 cases out of 10,000 newborns. Children with hypoplastic left-heart syndrome can have comorbid congenital anomalies and acquired diseases that require treatment and are associated with high mortality risk.Description of a clinical case. Female patient, 6 years 4 months, with the hypoplastic left-heart syndrome was admitted to our hospital with the diagnosis «Sensorineural hearing loss, speech delay» for performing of cochlear implantation. The council of physicians was convoked before the surgery to coordinate patient management. Members of surgical, anesthesiology, laboratory and instrumental examination departments were involved into preoperative assessment and planning due to the high level of surgical and anesthetic risk. The patient was dismissed from hospital on the 10th day after cochlear implantation. The patient has undergone the course of auditory-verbal therapy a month after. The child was dismissed wit state improvement.Conclusion. The example of successfully performed surgery in the patient with hypoplastic left-heart syndrome and such severe comorbid pathology as sensorineural hearing loss is presented. Complete physical examination of the child in preoperative period and adequate preparation for the surgery were the key factors for patient successful management and further rehabilitation