Functional evaluation of the upper extremities after corrective surgery of congenital defects of the aortic arch in children depending on arterial vascularisation

Abstract

Congenital heart defects are often accompanied by defects in great vessels, such as aortic coarctation with various forms of aortic arc hypoplasia, vascular rings and positional anomalies. Surgical treatment and the choice of optimal defect correction technique in the child may affect the restoration, maintenance or the arrest of blood supply by the aorta to arterial vessels given off by the aortic arch. Proper, closest physiological vascularisation of individual parts of the body and organs is necessary for proper development and maintenance of physiological function. The consequence of the use of various strategies for correcting congenital defects of the aorta and the use of available surgical techniques may be perfusion disorders, also in the field of vessels supplying upper limbs, most often the upper left limb. In this article, we have attempted to develop a universal strategy for assessing the development and function of the upper extremities in children. It consists of cardiac methods of cardiovascular evaluation and physiotherapeutic function tests of the upper limbs adapted to the age of patients. Confirmation of the long-term importance of maintaining or restoring the blood supply by the aorta on the basis of objective function tests of the upper extremities may be an additional argument while choosing the optimal surgical method in the youngest children.