METHOD OF SURGICAL TREATMENT OF ACUTE PULMONARY EMBOLISM OF HIGH AND INTERMEDIATE HIGH RISK Russian patent published in 2023 - IPC A61B17/00 A61B18/04 

FIELD: medicine, cardiovascular surgery.

SUBSTANCE: median sternotomy is performed, the pericardium is opened, and a heart-lung machine is connected. Then an arteriotomy incision is made 1.5 cm distal to the pulmonary valve, with a transition to the left pulmonary artery (LA). One external coronary suction is immersed in the output section of the right ventricle, the second — in the lumen of the interested branch of the pulmonary artery. The stage of thromboembolectomy is carried out from the trunk and main branches of the pulmonary artery under direct optical control until adequate retrograde blood flow is obtained. Thrombotic masses are removed, the wound on the LA is sutured with Prolen 4.0 thread. Radiofrequency ablation (RFA) of the LA and its branches is carried out in the area of the anterior wall of the LA at the bifurcation, moving to the main branches, a monopolar electrode is applied to the endocardial wall of the LA pointwise in rows in two lines — in a checkerboard pattern.

EFFECT: method allows to expand the possibilities of open surgical treatment, minimize intraoperative traumatization of intracardiac structures of the heart, does not require the use of cardiopulmonary bypass during the RFA stage of the operation, eliminates the effects of residual pulmonary hypertension, significantly reduces the number and severity of postoperative complications, determines the rapid development of reverse remodeling parameters of the right heart which is reflected in the improvement in the quality of life of patients after surgery.

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