METHOD OF IMPLANTING MITRAL HOMOGRAPH IN TRICUSPIDAL POSITION Russian patent published in 2023 - IPC A61B17/00 A61F2/24 

FIELD: medicine, cardiac surgery.

SUBSTANCE: septal leaflet of the tricuspid valve is left entirely, or it is partially preserved at a distance of 10–20 mm from the fibrous ring of the tricuspid valve. Then the mitral homograft is prepared for implantation as follows: the length of the anterior leaflet of the mitral homograft from the fibrous ring to the free edge in the A2 segment projection is measured. Next, the distance from the fibrous ring to the anterolateral papillary muscle in the area of the anterolateral commissure is measured. Similarly, the distance from the fibrous ring to the posteromedial papillary muscle in the area of the posteromedial commissure is measured. The distance between the middle points of the heads of the papillary muscles is measured. Then, before suturing the interventricular septum to implant the papillary muscles of the mitral homograft, the measured distances from the fibrous ring of the tricuspiad valve in the area of the anterospetal and anteroposterior commissures to the interventricular septum are compared. The interpapillary distance is measured, projecting onto the interventricular septum, and the papillary muscles of the mitral homograft are implanted to the interventricular septum, stitching them from the outside inside so that the threads come out from under the leaflets and are located on top of the corresponding commissures. The threads are not tightened and the mitral homograft fixed to the interventricular septum is placed in the fibrous ring of the tricuspid valve and fixed to it with two threads, starting from the anterolateral and posteromedial commissures clockwise, after which the support ring is implanted.

EFFECT: method allows to increase the effectiveness of surgical treatment of patients with damage of the tricuspid valve, by preserving the septal leaflet of the tricuspid valve, besides, it allows to minimize the risk of developing iatrogenic life-threatening cardiac arrhythmias, maintain annulopapillary continuity, which will significantly reduce the risk of developing right ventricular failure and remodeling of the right ventricle in the postoperative period. period, and also exclude the possibility of cutting through the seams.

1 cl, 5 dwg, 3 ex