The only( common) ventricle

With a single ventricle, both the valves from the atria( or the common valve) open into a single cavity, from which the aorta and pulmonary artery depart. There are different names of the defect: a single ventricle, a three-chambered heart, etc. The frequency of a single ventricle is 1-3% of all congenital heart defects. In newborns, it has a frequency of 1: 6500 children. Significantly more common vice occurs in boys, with a sex ratio of 2: 1-4: 1. The first description of the defect refers to 1814.

With this heart disease, often( in 40% of cases), an abnormal arrangement of internal organs occurs in combination with an abnormal positionheart( location on the right, left or in the middle of the thoracic cavity) and lack of a spleen.

With a single ventricle, all systemic arterial and venous blood is collected in a common chamber, where it is mixed. The volume of blood discharged into the aorta and the pulmonary artery will be determined by the resistance and the size of the clogging of both vessels. Without concomitant narrowing of the pulmonary artery, pulmonary hypertension( increased pressure in the pulmonary artery system) and heart failure rapidly develop. When combined with a narrowing of the pulmonary artery, the flora proceeds more favorably and resembles the tetralogy of Fallot. Oxygen saturation in the aorta is reduced and is determined by the amount of oxygenated blood entering the common chamber. Without the concomitant narrowing of the pulmonary artery, oxygen saturation of the blood can be almost normal. In this case, the cyanosis of the skin is slightly or completely absent. In cases of a combination with stenosis of the pulmonary artery, the quantity of oxygen-enriched blood decreases, the lack of saturation of blood with oxygen is aggravated, which leads to pronounced blueness of the skin.

The only ventricle is more often diagnosed shortly after birth, and in 2/3 of the children during the first 6 months of life. In the absence of stenosis of the pulmonary artery soon after birth, there are repeated pneumonia, lag in physical development, dyspnea, congestive wheezing in the lungs, increased heart rate, liver size increases. Cyanosis of the skin in such cases is poorly expressed( the skin has a blue hue), is located on the lips and fingertips. In doubtful cases, the determination of blood saturation with oxygen is carried out. All emerging manifestations of this defect often resemble the defect of the interventricular septum with a large discharge of blood from left to right( i.e., into the small circle of circulation).Auscultation hears a characteristic noise.

When a single ventricle is combined with stenosis( constriction) of the pulmonary artery, there is a cyanosis of the skin, the severity of which is directly proportional to the intensity of narrowing of the lumen of the vessel. Cyanotic staining of the skin is greatly enhanced when the child cries. Over time, the deformation of nails by the type of "watch glass" and fingers like "drumsticks" develops. Heart failure, as a rule, is absent. When you feel the area of ​​the heart is determined by the trembling. The border of the heart in most cases remain normal. When listening to the heart, the doctor determines a characteristic coarse noise.

Additional methods of examining a child are ECG, chest X-ray, ultrasound of the heart. Invaluable help for detecting blemish is ultrasound of the heart after the introduction of contrast medium.

Most of the children with a single ventricle die in the first months of life. The course is more favorable when combined with stenosis( constriction) of the pulmonary artery. In the first months of life with increased pressure in the pulmonary artery, surgical treatment is possible, in which a special artificial narrowing of the lumen of the pulmonary artery occurs, which helps to reduce blood flow through the lungs and prevents the development of congestive heart failure preventing sclerotic changes in the pulmonary vessels. Concomitant stenosis( narrowing) of the pulmonary artery, pronounced cyanotic staining of the skin, lag in physical development also require an operation. Radical surgical treatment became possible only recently. In this case, the interventricular septum is prosthodinated with the help of special synthetic tissues.