METHOD FOR SURGICAL TREATMENT OF ACUTE PULMONARY EMBOLISM OF HIGH AND MEDIUM-HIGH RISK Russian patent published in 2023 - IPC A61B17/00 A61B18/02 

FIELD: medicine.

SUBSTANCE: invention relates to the field of medicine, namely, to cardiovascular surgery. Sternotomy is performed, connecting parallel artificial circulation by cannulation of the ascending aorta and isolated cannulation of the entries of both hollow veins, without applying a clamp to the aorta. Arteriotomy of the pulmonary trunk is performed starting 1.5 cm above the pulmonary valve and ending 1 cm beyond the entry of the left pulmonary artery, with continuous vacuum aspiration from the entries of the right and left pulmonary arteries with a 200 to 300 mmHg dilution. Open thrombectomy is performed from the right and left pulmonary trunk, followed by radio frequency circular denervation of the adventitial layer the pulmonary trunk and entries by applying three applications, evenly distributed over the surface of the vessel, with a radio frequency destructor 2 cm proximal to the pulmonary trunk bifurcation with an output power in the range from 22.8 to 28.5 W for 10 to 15 seconds with a frequency of 460 kHz under the control of the impedance of the vascular tissue, wherein the application is stopped when the impedance of the vessel tissue reaches a value of half the impedance of the vessel tissue determined at the beginning of application. Similar three applications are then performed at the entries of the right and left pulmonary arteries 1.5 cm distal to the bifurcation.

EFFECT: possibility of improving the results of surgical treatment of high and medium-high risk PE by performing embolectomy from the distal pulmonary arterial bed with more sparing techniques used to reduce the possibility of injuring the intima and damaging the vascular wall with the development of pulmonary bleeding; elimination of postoperative pulmonary hypertension and peripheral vasoconstriction of the precapillary bed associated with irritation of the nerve plexi located in the adventitia of the trunk and entries of the pulmonary arteries; artificial circulation conducted without cardiac arrest.

1 cl, 2 ex, 3 dwg