METHOD FOR SURGICAL TREATMENT OF AORTIC DISSECTION WITH DAMAGE TO BRACHIOCEPHALIC ARTERIES, SYNTHETIC FOUR-BRANCHED VASCULAR PROSTHESIS FOR ITS IMPLEMENTATION AND METHOD FOR MANUFACTURING PROSTHESIS Russian patent published in 2021 - IPC A61F2/06 A61B17/00 

FIELD: medicine, medical equipment.

SUBSTANCE: group of inventions relates to medicine and medical technology, namely to cardiovascular surgery. There are aortic arch, brachiocephalic trunk, right subclavian artery, right common carotid artery, left common carotid artery, left subclavian artery. The left axillary artery is cannulated, the arteries damaged by dissection are gradually cut off, and a synthetic four-branched vascular prosthesis is implanted. At the same time, vascular anastomoses of three brachiocephalic arteries with branches of a four-branched prosthesis are formed, starting with the right common carotid artery and the right subclavian artery, then the left common carotid artery, with temporary shunting and providing blood flow from the left axillary artery. Artificial blood circulation is connected at 26 °C through the left axillary artery and hollow veins with blood supply to the brain through the main branch of the four-branched vascular prosthesis. Prosthetics of the ascending aorta are performed, then prosthetics of the stratified aortic arch in hypothermia with a stop of systemic artificial blood circulation and cerebral perfusion through the main branch of the four-branched vascular prosthesis and the left axillary artery. The mouths of the left subclavian artery are cut off within the intact vessel. A distal anastomosis of the vascular prosthesis of the aortic arch with a descending thoracic aorta is formed. Systemic artificial blood circulation is restored through an additional branch of the aortic arch prosthesis. An anastomosis is formed between the fourth branch and the left subclavian artery. The main branch of the four-branched vascular prosthesis is released after the formation of all four anastomoses between the branches and the brachiocephalic arteries and cerebral perfusion is performed through the left axillary artery. An intervascular anastomosis is formed between the ascending section and the aortic arch. Cardiac activity is restored. An intervascular anastomosis is formed between the main branch of the four-branched vascular prosthesis and the ascending section. Artificial blood circulation is stopped after hemodynamic stabilization. At the same time, the four-branched vascular prosthesis is made in an original way.

EFFECT: group of inventions makes it possible to preserve cerebral blood flow at all stages of surgical intervention, to restore blood supply to all brachiocephalic arteries in patients with damaged brachiocephalic arteries with aortic dissection.

8 cl, 3 dwg, 2 ex