Biography Mikhail Abramyan

When a child is born with a pathology of the heart, he needs timely and qualified help than ever. The work of the Cardiac Service of the Morozov hospital “VM” was told by its leader, the chief children's cardiac surgeon of the capital's department of health, Mikhail Abramyan. And, of course, not because someone suddenly wanted to. The reasons are in the needs of the city and patients.

The decision that in Moscow there should be a children's cardiac surgery, it was brewed for a long time and it was dictated, first of all, the prevalence of diseases of the cardiovascular system and its negative contribution to the structure of children's mortality. That is why the city government thought about expanding the possibilities of providing both surgical and therapeutic assistance to children with cardinal pathology.

If we are talking about surgery, then these are mainly congenital heart defects. And here we see numbers that statistically do not change throughout the world for many decades: from 0.8 to 1 percent of all children are born with congenital heart defect. But what is even worse, if you look at an indicator of infant mortality from congenital malformations, then exactly half of all cases are associated with heart disease.

Therefore, it is so important to provide high-quality, qualified assistance to children with pathology of the cardiovascular system. More than a third of children who are born with heart defects, without timely surgical intervention either die or become critical patients during the first year of life. That is why another such large cardiac surgery appeared in Moscow.

In the work of any unit, no matter how well it is equipped, people play a leading role. Therefore, creating our service, we paid special attention to the selection of specialists: it is impossible to work in cardiac surgery if there is no team spirit. Very often, the work of the cardiac surgery is compared with the pit stop during the Formula-1 races, when several people change all the wheels in a matter of a few seconds, season it and so on.

So with us. One person cannot do everything himself. Here, each person plays his colossal role. There are 10 employees in the operating room at the same time, and each of them makes a huge contribution to the treatment of a small patient who lies on the operating table. This is what important. Yes, we have excellent modern equipment, both diagnostic and therapeutic, but it will not save anyone without people.

In Moscow, on average, thousands of children are born a year. Accordingly, babies, according to statistics, are born with congenital heart defects. In emergency surgical care in the first months, and sometimes in the first days of life, 30 percent of these children need, that is, the order of babies. But if we look at real numbers, then they will be much less.

Because timely diagnosis is very important. And this is a problem not of our country, but the whole world. All civilized countries work on improving the quality of early diagnosis of heart pathology. A heart disease is not some kind of external pathology that is immediately striking. Moreover, in the early days of the child’s life, even the most critical vices often do not have external manifestations, so it is so important for children to be screening for the presence of congenital heart disease that has just born.

The Moscow Department made such an important decision in the year, and now this procedure is mandatory for all babies, which, of course, has somewhat improved indicators of the detection of congenital heart defects. Nevertheless, we need to move on, so now we have the task of improving the quality of prenatal diagnosis, that is, to meet the baby with a congenital heart defect, which is still in the womb.

But if we are talking about prenatal diagnosis, then here the question is not so much of our department as obstetric hospitals and women's consultations, where pregnant women come, and where they carry out the very screening diagnostics, including ultrasound. We have a multicomponent task, which we must solve together with obstetrician-gynecologists, children's cardiologists and neonatologists.

Moreover, not all of our patients need emergency care. It all depends on what kind of pathology the child has. Some vices need to be operated on in months after birth, some-after the first year of life, and in some cases you can wait until the years. Everything has the optimal time for surgical correction. Plus, there is stage treatment, that is, it happens that in the period of the newborn we made the first stage of surgical treatment, after a few months we completed the second stage, after a couple of years - the third.

In our profession, unfortunately, not all vices can be eliminated from the first operation, so there is the so -called accumulated incidence: children who from year to year go into the category of patients in need of surgery.Since the opening of the department, we operated on not only newborns, but also children 7, 11, 12 years old, that is, completely different ages. It does not apply to innate heart defects, but very dramatic in the development of events and could lead to catastrophic consequences.

We received a seven -year -old child with myocarditis. This is an inflammatory myocardial disease, when the heart begins to cope poorly with its work, because it is affected by an infectious agent. In a child, a blood clot formed in the cavity of the left ventricle of the heart. Despite the fact that we carried out all the necessary therapy, this thrombus, when the patient, in principle, was recovering in his state, broke away and flew into the vessels of the lower extremities, causing acute ischemia of the left leg.

That is, the broken blood clot completely closed the femoral vessels. The child experienced incredible pain. Worse that everything could end with amputation of the leg. It was necessary to act quickly. And here, in addition to the team spirit, it helped us that we are in a multidisciplinary hospital. Hematologists immediately connected to work. Part of the vessels managed to restore medication, after which we took the child to the operating room and removed all the blood clot from the femoral artery, completely restored its cross -country ability, and now the whole threat has passed.

And here we have a lot of patients with arterial hypertension, with inflammatory myocardial diseases, with heart rhythm disorders. Unfortunately, diseases of the cardiovascular system are very young. And here are at least two main reasons. Firstly, bad habits. Alas, the children began to smoke more actively, drink alcoholic drinks, which, to put it mildly, does not affect the growing organism very well.

Hence a large amount of hypertension. Secondly,, unfortunately, technological progress plays their negative role: children are sitting in their gadgets all the time, they do not move. And hypodynamia is the main problem that leads to the pathology of the cardiovascular system. As a result, we are now treating summer children, which were previously characteristic only for the elderly. For example, arterial hypertension.

A complete cure is possible? The doctor will cure a tablet. This is not a problem to give the child the right medicine in order to reduce blood pressure. But we are trying to explain to our parents, to reach out to the guys themselves, that while the situation is reversible, it is necessary to change the lifestyle - to abandon salt and sweets, to follow their weight, not to overeat, not to smoke, to move more - and then over time the pills will not be needed.

And it seems that everything understands everything, but five minutes after the conversation you go into the ward and see that the child is lying on the bed again and looking at the smartphone. Why am I saying all this? The disease is much easier to prevent than to treat. Therefore, the prevention of a healthy lifestyle should come to the fore. To change something, doctors need help, including the media.

In my opinion, there should be more social videos on the prevention of cardiovascular diseases that need to be shown on the Internet and on TV. This is very important and necessary so that we get a healthy generation.