DEPARTMENT OF INTENSIVE CARDIOLOGY FOR CHD PREMATURE NEWBORNS AND INFANTS (DICP)

The Department of intensive cardiology for CHD premature newborns and infants (DICP) was founded in 1999.

The department performs the entire range of cardiac surgical interventions in newborns and infants, provides cardiac surgical care to children from the first hours of their life, including newborns in extremely severe and critical conditions.
Particular attention is paid to the development of diagnostic examination and management patterns of premature and low birth weight (less than 2.5 kg) infants with critical congenital heart defects.
Patients undergo a complex diagnostics of heart and blood vessels congenital diseases using advanced techniques and expert-class equipment. Doctors determine the tactics of management and conduct therapeutic preparation with subsequent surgical treatment of small patients with any nosological form of congenital heart defects.
An important part of the department's clinical work is advisory assistance to maternity hospitals and children's medical institutions in Russia. The employees of the department are actively involved in the telemedicine activities of the Center.
Much attention is paid to the training of young specialists of “cardiovascular surgery” and “pediatric cardiology” fields and to the work to improve the skills of the graduates.
The doctors of the department study the long-term results of aortic coarctation repair in the neonatal period - they examine patients aged 5 to 18 years, develop protocols for the management and correction of residual and comorbid pathology in such children.

The DICP performs the whole range of surgical operations, in case of typical as well as rare congenital heart defects:

• Norwood operation for hypoplastic left heart syndrome
• Damus–Kaye–Stansel operation for complex CHD
• Operation of cavopulmonary anastomosis for children with complex CHD, including children after Norwood and Damus–Kaye–Stansel operations
• Reconstructive operations for interrupted and hypoplastic aortic arch under adaptive perfusion
• Multi-stage surgical treatment of pulmonary atresia
• Correction of the transposition of the main arteries with complex anatomical variants of the origin of coronary arteries
• Heart tumor excision followed by cryoablation of its bed
• Complete repair of the common arterial trunk in newborns using a conduit from the jugular vein of a bull (patent for the invention of FSBI “A.N. Bakulev NMRC for Cardiovascular Surgery”)
• Staged complete repair of the common arterial trunk with agenesis of the left pulmonary artery
• Total repair of tetralogy of Fallot with preservation of the pulmonary valve obturator function
• Complete repair of total anomalous pulmonary vein drainage using "seamless" technique
• Staged repair of tetralogy of Fallot with marked hypoplasia of the pulmonary artery system
• Suturing of a giant coronary fistula under CPB
• Open valvuloplasty for aortic valve stenosis

Department staff performed in 2022:

• 1024 field consultations in maternity hospitals and neonatal intensive care units in Moscow and the Moscow region
• 235 telemedicine consultations, 58 of which were emergency, 195 patients were hospitalized.

Totally, 570 patients were hospitalized to the department in 2022, 341 operations were performed. Hospital mortality was 2.5% (2.8% in 2021). 158 (in 2021-146) operations were performed with cardiopulmonary bypass. Despite the increasing complexity of cardiovascular pathology and comorbidities, including low weight (less than 2.5 kg) patients, mortality during operations with CPB is steadily declining: 6.7% in 2020, 5.5 % in 2021, 2.5% in 2022. As a rule, fatal cases occur during the repair of critical heart defects in cases of complex anatomical forms of CHD in combination with severe comorbid pathology.

The department has 15 children beds, which are distributed in 12 wards:

• 2 shared wards with 4 beds each
• 6 wards for a separate stay of a child with a parent (legal representative) with separate sanitary rooms. One of these wards is a 2-room ward, equipped with a separate fridge, microwave, TV-set and a sanitary room
• a ward for newborns
• an intensive care ward
• 2 isolated wards

The department has individual lockers for storing personal belongings, a kitchen and a recreation room for parents and shower rooms. Adults who are in the department with young patients are provided with a bed and three meals a day. The department also has a children kitchen with special equipment for preparing infant formula milk and sterilizing bottles.