METHOD FOR AORTIC ARCH PROSTHESIS FOR DAMAGED BRACHIOCEPHAL ARTERIES, SYNTHETIC VASCULAR AORTIC ARCH PROSTHESIS FOR ITS IMPLEMENTATION AND METHOD OF ITS MANUFACTURE Russian patent published in 2022 - IPC A61B17/00 A61F2/06 A61K31/727 A61K31/616 A61K31/505 A61K31/4164 A61K31/4709 A61K47/42 A61K31/11 A61K47/10 A61P43/00 

FIELD: medicine; medical technology.

SUBSTANCE: inventions group relates to medicine and medical technology, namely to cardiovascular surgery. In case of hypothermia at 26°C and stopping the systemic IC, the damaged aortic arch is dissected. The mouth of the left subclavian artery is cut off and clamped. A distal anastomosis is formed with the descending part of the thoracic aorta by installing the distal part of the vascular prosthesis of the aortic arch inside the descending part of the thoracic aorta. After that, the "skirt" -cuff is sewn to the descending part of the thoracic aorta, then the systemic IR is restored through the additional branch of the aortic arch prosthesis. A clamp is applied to the proximal part of the arch prosthesis. An anastomosis is formed between the third branch of the trifurcation prosthesis and the left subclavian artery. An intervascular anastomosis is formed between the prostheses of the ascending part and the aortic arch. The main branch of the aortic arch prosthesis is clamped and, after the prevention of air embolism, cardiac activity is restored. On the beating heart, an end-to-end intervascular anastomosis is formed between the main jaws of the trifurcation prosthesis and the main jaws of the aortic arch prosthesis. After stabilization of hemodynamics, IC is completed. The specified method is implemented by means of a synthetic vascular prosthesis of the aortic arch, which includes a main branch, an additional perfusion branch and a "skirt" -cuff. The specified prosthesis is made by fixing a woven knitted cuff in the form of a flat ring to a linear vascular prosthesis of the aortic arch. Then an additional branch of the aortic arch prosthesis is formed by suturing a vascular synthetic prosthesis with a diameter of 8 mm to a linear vascular aortic arch prosthesis with a "skirt" -cuff. After that, the main branch of the aortic arch prosthesis is formed, for which the linear vascular prosthesis is sutured at an angle to the linear vascular aortic arch prosthesis with a "skirt" cuff and an additional branch. Then a multilayer coating is applied to the surface of the product, where the first layer is a layer of protein, the second is a layer of anticoagulant - heparin, the third is a layer of a biodegradable coating based on gelatin and drugs with antimicrobial and antiplatelet action, while glutaraldehyde is used as a crosslinking agent, and plasticizer - glycerin, then the resulting prosthesis is sterilized with ethylene oxide at 37°C.

EFFECT: inventions group makes it possible to preserve cerebral, cardiac and visceral blood flow at the stage of end-to-end intervascular anastomosis between the main branch of the aortic arch prosthesis and trifurcation prosthesis on the beating heart in patients with dissection of the ascending part and the aortic arch.

7 cl, 3 dwg, 1 ex