METHOD FOR SURGICAL TREATMENT OF CONGENITAL AORTA ARCH BREAK IN INFANTS AND NEWBORNS Russian patent published in 2022 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to cardiac surgery. A median sternotomy is performed, providing access to the heart and great vessels. The aortic arch with branches and the descending aorta are separated from the area of ​​the aortic arch interruption under cardiopulmonary bypass. Separate cannulation of the ascending and descending aorta is performed for separate perfusion of the upper and lower parts of the patient's body. The branches of the pulmonary artery are clamped at the time of the start of cardiopulmonary bypass. A cardioplegic solution is administered after clamping the ascending aorta and cutting off the pulmonary artery trunk from the base of the ductus arteriosus on the stopped heart. Next, an autograft is taken in the region of the anterior wall and side walls of the pulmonary artery trunk, above the level of the valve ring and at a safe distance from the semilunar cusps, commissures, and orifices of the pulmonary artery branches. Pulmonary artery trunk plasty is performed using a patch from the pericardial tissue, the aortic cannula is removed from the descending aorta, and selective brain perfusion is started. Then the aortic arch is opened along the internal curvature with the transition to the upper third of the ascending section, the descending aorta, clamped distally, is cut off from the ductal tissues and opened longitudinally, after which, using a prepared patch cut from the own wall of the pulmonary trunk, the posterior semicircle of the aortic arch is formed along type of "bridge", and the second patch, cut from the homograft, forms the anterior wall of the anastomosis with fixation with a continuous vascular suture. After that, the air is displaced, the clamp is removed from the descending aorta and full perfusion of the body is resumed, then the clamp is removed from the ascending aorta, and the operation is completed.

EFFECT: method makes it possible to eliminate the aortic arch interruption at the initial significant interruption and to achieve hemodynamic parameters close to normal.

1 cl, 1 ex, 4 dwg