FIELD: medicine.
SUBSTANCE: heart and great vessels are approached through a median sternal incision. The patient is connected to a cardiac pump. The patient's temperature is reduced to moderate hypothermia. That is followed by separating the aortic arch, branches and the descending aorta in the distal direction from the stenosis. After the ascending aorta, branches of the aortic arch, the descending aorta have been clamped in the distal direction from the stenonsis, a stenotic segment of the aorta is excised. An end-to-end anastomosis is created between the distal end of a vascular graft of a normal diameter and the descending aorta. Thereafter, the aortic arch is incised along the lower border up to the distal one-third of the ascending aorta. The proximal end of the vascular graft is cut at an acute angle of 30-60° facing the ascending arch; a diameter equal to the pre-incised aortic arch is formed. An end-to-end anastomosis is created between the lower border of the aortic arch and the proximal end of the vascular graft. Actions are taken to prevent air embolism; the aorta and its branches are unclamped. The patient is heated to normal temperature.
EFFECT: method enables eliminating aortic coarctation and re-coarctation and accompanying hypoplastic aortic arch effectively with the lowest surgical risk.
3 dwg, 2 ex
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Authors
Dates
2015-09-20—Published
2014-12-17—Filed