METHOD OF INFRACORONARY EXTRAANNULAR IMPLANTATION OF AORTIC VALVE PROSTHESIS Russian patent published in 2024 - IPC A61F2/24 A61B17/00 

FIELD: medicine; cardiovascular surgery.

SUBSTANCE: access to the native aortic valve is created by completely transecting the aorta along the line of the sinotubular ridge. Then the leaflets of the native aortic valve are excised. Then the outer wall of the aortic root - the area located under the coronary arteries is isolated from the surrounding tissues. Then, a pre-cut strip of Dacron 5 mm wide and 140 mm long is placed around the circumference of the aortic root along the line located under the coronary arteries. Excess Dacron strips are cut off and a continuous contour of Dacron strips is formed around the aortic root without creating any duplication at its ends. The cuff of the aortic valve prosthesis, the wall of the aortic root and the Dacron strip are stitched with 15 U-shaped sutures, while needles with a synthetic braided thread for implanting heart valves are inserted into the cuff of the aortic valve prosthesis in the “top-down” direction, the aortic wall is stitched “from inside to outside”, the needle is poked through a strip of Dacron. When forming U-shaped sutures, 5 U-shaped sutures are placed on each 1/3 of the circumference of the aortic valve prosthesis, and 5 U-shaped sutures are placed on each 1/3 of the circumference of the aortic root, while maintaining the same distance between adjacent injections. The aortic valve prosthesis is placed in the aortic root so that its cuff is at the level of the threads injected into the aortic wall and corresponds to the Dacron strip located outside the aortic root. The aortic valve prosthesis is fixed to the aortic root by tying U-shaped sutures.

EFFECT: without increasing the volume of the operation, the method of infracoronary extraannular implantation of an aortic valve prosthesis allows to implant an aortic valve prosthesis 1–2 seat sizes larger than what the basal ring of the aortic root can accommodate, thereby reducing the risk of developing the syndrome of “prosthetic valve mismatch with the patient”.

1 cl, 1 ex