FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to cardiovascular surgery. Left-sided thoracoscopic access to the heart is performed. The pericardium is opened above the mouth of the pulmonary veins (PV), surgical dissection of the transverse and oblique pericardial sinuses is performed. Then, with the help of a dissector, a conductor-marker is carried out around the left mouths of the PV. At the next stage, right-sided access is performed, the pericardium is opened, sutures are applied to the lower edge of the opened pericardium. A conductor is passed with a dissector around the right PVs, along which a radiofrequency bipolar clamp (RBC) is positioned for ablation, by means of which ablation lines are applied in the visibility zone from the right-sided access: on the right PV orifices, the roof of the left atrium, along the lower wall of the left atrium. Then, the bipolar clamp for RBC is moved into the previously installed conductor-marker, and bipolar ablation of the orifices of the left PVs is performed from the left-sided access, connecting the ablation lines with the lines from the right-sided access.
EFFECT: method makes it possible to exclude perforation of the main vessels and chambers of the heart, excessive or insufficient ablation effect, as well as to avoid thermal injuries of the esophagus and phrenic nerves.
1 cl, 2 ex
Authors
Dates
2022-10-21—Published
2022-03-19—Filed