METHOD FOR OPENING HEART IN ACUTE MYOCARDIAL INFARCTION Russian patent published in 2020 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to pathoanatomical anatomy. Posterior and anterior walls of the right and left ventricles of the heart are incised from the atrium in the cavity of the right and left surfaces of the interventricular septum. Tripod for intravenous transfusions is preliminary installed; at that, 500 ml bottle is filled with water with an eosin solution at ratio of 1:1, the system for intravenous transfusions is connected to a flask filled with a contrast solution and fixed with a clamp. That is followed by exposing a pericardial sac, determining the amount and condition of the liquid in the pericardial cavity, evaluating a condition of the coronary arteries: a left coronary artery (LCA) and its branches - a circumflex artery (CA) and an anterior interventricular branch (AIB); right coronary artery (RCA), presence of rupture and haemorrhages, density, tortuosity, submergence in the underlying organ tissues. Aortic arch is incised 2–3 cm long along the vessel. Coronary artery mouths are identified. Then catheters are alternated to them. Thereafter, the catheter is connected to a system for intravenous injections, to judge the patency of the coronary arteries, a contrasting examination of the LCA and the RCA is performed. Clamp is loosened in the system and the time of beginning of the eosin solution delivery into the cardiac vessels is recorded. For 50–60 seconds, this solution fills the coronary artery with painting of the main part of the vessel and its collaterals. Further, coronary vessels are dissected along the blood flow taking into account data of their contrast examination, precise location of stable and unstable fibrous plaques, thrombotic masses and other pathological changes. That is followed by sampling fragments of anterior interventricular artery, envelope artery, right coronary artery, both unchanged and atherosclerotic affected areas. Thereafter, the posterior and anterior walls of the right and left ventricles of the heart are incised from the atrium in the cavity of the right and left surfaces of the interventricular septum. Then complete separation of two walls of ventricles and interventricular septum is achieved. Weight parameters of each heart are measured; the heart is divided into five parts: 1) epicardial fat with vessels and valves (EF); 2) atrium with an interatrial septum (IS); 3) free wall of left ventricle (L); 4) free wall of right ventricle (R); 5) interventricular septum (IS). Auricles are separated from the ventricles by a coronary sulcus. Epicardial tissue is removed by means of curved scissors. Said parameters are summed up to make total heart weight (HW). Then, pure heart weight (PHW) is calculated. Right ventricular (RV) weight is determined by formula. Left ventricular (LV) weight is determined by formula. Right ventricular index (RVI) is determined as a percentage of right ventricular mass to net cardiac weight. Left ventricular index (LVI) is calculated by formula as percentage of left ventricular mass to net cardiac weight. Ventricular index (VI) is calculated as a ratio of right ventricular mass to left mass. Myocardial-growth index (MGI) is calculated as a relation of net heart weight to height. If observing the extent of myocardial injuries, stereometric measurements are used, for this purpose, the left and right ventricles and the interventricular septum are cut horizontally into plates 0.5–1.0 cm. Then the appropriate area of all plates of the examined heart is determined using a ruler. That is followed by determining the percentage of affected myocardium. That is followed by calculating the area of the lumen of coronary arteries (S) based on the length of their circumference (perimeter), the length of the inner circumference of the RCA at distance of 2–3 ml from the entrance, the anterior interventricular artery (AIA) and the CA branches of the left coronary artery at the level of bifurcation. Heart's blood-flow index (BFI) is calculated as a ratio of the total heart weight to the total area of the coronary artery lumen (CAL). Thereafter, content of free water in tissues of left ventricle, right ventricle, interventricular septum is determined by formula.

EFFECT: method enables higher information value of analysis and accuracy of thanatogenesis evaluation.

1 cl, 2 ex