METHOD OF TREATING INFECTIOUS ENDOCARDITIS, BIOLOGICAL VALVE CONTAINING CONDUIT OF ASCENDING AORTA FOR ITS IMPLEMENTATION AND METHOD FOR CONDUIT MANUFACTURE Russian patent published in 2019 - IPC A61B17/00 A61F2/06 A61F2/24 

FIELD: medicine.

SUBSTANCE: group of inventions relates to medicine and medical technology, namely to cardiovascular surgery. After mobilization of the aorta, crystalloid pharmaco-hypothermic cardioplegia is performed, transverse aortotomy is performed and the foci of infection and the edges of abscesses are sanitized, which are then refreshed. Treat abscesses and fibrous ring cavity with antiseptic solutions. Wash the cavity of the heart with dioxidine solution with removal of wash water. Prepare manufactured biological valve containing conduit. Conduit is implanted in the supra annular position on 16–19 U-shaped sutures on a strip of polytetrafluoroethylene to the fibrous ring of the aortic valve or to uncompromised infection of the heart tissues. Needle is passed through the unchanged infectious process of the tissue of the excretory section of the left ventricle. Threads are brought out, they are stitched and the cavities of abscesses and foci of tissue destruction of the aortic root are cut off from the bloodstream by the walls of the xenopericardiac conduit base. Anastomoses are formed with the right and left coronary arteries and a distal anastomosis is performed between the ascending aorta and the ascending part of the xenopericardiac conduit, the incomplete lateral suture of which allows to accurately compare the diameter of the conduit with the ascending aorta. Method of manufacturing a biological valve-containing conduit of the ascending aorta involves suturing the aortic valve prosthesis cuff to the descending part of the tubular base, which is formed by stitching the sides of the xenopericardiac flap along the entire length of the descending part and stitching the sides on the portion of the ascending part. According to the analysis of the anatomy of the ascending aorta, carried out with the help of ultrasound, magnetic resonance studies or studies on a computer tomograph, perform cutting of a xenopericardiac flap in the shape of a rectangle with a width equal to the circumference of the aortic valve prosthesis with an allowance for a side seam. Sides are stitched with an outer double blanket stitching, which starts from the ascending part, is performed for the entire length of the descending part and is continued for 10–30 mm of the ascending part. Excess suture material is fixed for intraoperative extension or shortening of the side seam. Cuff is sewn with a double blanket return stitch to duplicator. Duplication is formed at the junction of the descending and ascending parts by inverting the descending part outward. Descending part after sewing on the cuff is returned to its original position. Biological valve-containing conduit of the ascending aorta contains a prosthetic aortic valve with a cuff and a tubular base of a xenopericardiac flap. Lateral sides of the xenopericardiac flap are stitched along the entire length of the descending part and in the region of the ascending part with a length of 10 to 30 mm. Valve cuff is sewn to duplicator tubular base, made at the junction of the descending and ascending parts.

EFFECT: group of inventions allows to reduce the time of surgical intervention, to reduce the risk of repeated interventions through the use of a biological vascular conduit with an aortic valve prosthesis inside its vascular part, completely ready for implantation, provides full restoration of functions of the replaceable area of the ascending aorta with the aortic valve of the patient or their prostheses due to the elastic-strength properties of biological conduit suitable for these purposes, the absence of recurrent endocarditis with the formation of thrombi, absence of abscesses and paraprosthetic fistulas, as well as due to reliable strengthening of the aortic valve fibrous ring with biological conduit cuff.

14 cl, 3 dwg, 1 tbl, 3 ex