FIELD: medicine.
SUBSTANCE: invention relates to medicine, in particular, to cardiovascular surgery. Transposition of the brachiocephalic trunk is performed with preserving cerebral perfusion by means of a temporary shunt. Temporary shunt proceeds and tightly fixed to the distal end of the right branch of the bifurcation synthetic prosthesis and is passed into the lumen of the dissected brachiocephalic trunk through a transverse incision in the distal end of the left branch. End-to-end anastomosis is formed between the brachiocephalic trunk and the left branch of the bifurcation prosthesis. Temporary shunt is removed from the lumens of a brachiocephalic trunk and a left branch with restoration of its tightness by a pre-applied purse-string suture with restoration of blood flow along the right internal carotid and subclavian arteries. After that, using the right branch blood flow is sequentially switched to the left common carotid and left subclavian arteries. That is followed by a layer-by-layer closure of the wound and subsequent stent-graft implantation into the ascending, arch and thoracic aorta.
EFFECT: method enables reducing the time of cerebral ischemia by maintaining adequate arterial pressure and blood flow in the brachiocephalic arterial system when transposing into a vascular prosthesis and reducing a risk of the intraoperative complication in the form of ischemic stroke on the side of carotid artery clamping.
1 cl, 1 ex, 11 dwg
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Authors
Dates
2020-03-11—Published
2019-03-27—Filed