METHOD FOR REMOVING ENDOCARDIAL ELECTRODES UNDER THE VIDEOTHORACOSCOPY CONTROL IN PATIENTS WITH A HIGH RISK OF DAMAGE TO THE SUPERIOR VENA CAVA SYSTEM Russian patent published in 2021 - IPC A61B17/00 

FIELD: cardiovascular surgery.

SUBSTANCE: incision is made in the area of ​​the pacemaker and the stimulating system is dismantled, followed by insertion of the electrode to be removed into the lumen and fixation of the locking stylet. Next, a transition to isolated artificial ventilation (ALV) of the left lung is performed using a double-lumen endotracheal tube. On the right, two hybrid trocars with a thread and a tap are installed in the 5th intercostal space along the anterior axillary line of 10 mm and in the 6th intercostal space along the midclavicular line of 5 mm. A 10 mm 30° thoracoscope and an atraumatic fixing forceps are introduced through trocars, the superior vena cava is visualized. Using a rotary dilator, the electrode is freed from adhesions, thereby recanalizing the superior vena cava during its occlusion, while the electrode extraction and recanalization of the superior vena cava are carried out simultaneously and the endovascular manipulations are controlled by videothoracoscopy on the right. Subsequently, the electrode is removed after its isolation from the adhesions. In this case, visualization of the superior vena cava is carried out in order to control the stage of its recanalization and removal of electrodes, and timely detection of its damage.

EFFECT: method improves efficiency and safety of electrode extraction under videothoracoscopy control in patients with high risk of damage to the superior vena cava system.

1 cl, 2 ex