METHOD OF PERICARDIAL CLOSURE IN CORONARY ARTERY BYPASS GRAFTING Russian patent published in 2020 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to cardiosurgery. Pericardial flap is formed. Sternotomy is followed by separating the adipose tissue of the mediastinum and both pleural sheets from the anterior pericardium wall, forming a flap within the projection of the apex of the heart within the transition of the anterior wall of pericardium into the diaphragm portion from adipose tissue of the mediastinum. Left brachiocephalic vein is separated by dissecting a portion of the thymus above it, a left internal thoracic artery (LITA) is separated from the bifurcation to the subclavian vein. For LITA bed is formed from subclavian vein along caudal surface of brachiocephalic vein so that after opening of pericardium LITA entered into cavity of pericardium along left edge of pulmonary artery, "J-shaped" pericardial opening is performed along the place of contact of left pleural cavity sheet with pericardium. Incision is continued to the diaphragm surface of the pericardium, and then – towards the right pleural cavity, forming a triangular flap from the anterior wall of pericardium with its base on the side of the right heart, performing aortocoronary bypass. Apex of a triangular flap of a pericardium with a flap from an adipose tissue of a mediastinum and a diaphragm part of a pericardium in an apex of a heart, a forward wall of a pericardium with a fat tissue of a mediastinum – along lines of opening of a pericardium are closed an apex of a triangular flap.

EFFECT: method enables recovering the physiological differentiation of the pericardial cavity and anterior mediastinum.

1 cl, 1 ex, 10 dwg