Bokeriya Leonid Antonovich,Бокерия Леонид Антонович,Svobodov Andrej Andreevich,Свободов Андрей Андреевич
申请号：
RU2016135701
公开号：
RU0002622990C1
申请日:
2016.09.02
申请国别(地区):
RU
年份:
2017
代理人:
摘要：
FIELD: medicine.SUBSTANCE: longitudinal section of the right ventricular outflow (RVO) is performed to the middle of the anterior third of the fibrous pulmonary valve ring (PFR). Then, a longitudinal section of the pulmonary artery (PA) is performed to the middle of the anterior third of the PFR. The infundibular stenosis is excised. The diameter of the PFR is determined and, when it decreases, Z-score is less than -2, the anterior section of the PFR is skeletonized, separating it from the right ventricular myocardium and the wall of the pulmonary artery, for more than a third of the length of the PFR loop, not exceeding half of it. In doing so, previously made cuts are connected. Further, the xenopericardial patch is sewn into the edges of the cuts of the right ventricle and the trunk of the LA by means of a continuous suture joint with the formation of an additional exit from the right ventricle of the heart into the pulmonary artery trunk between the patch and the anterior wall of the PFR. At the same time, the patch is first sewn with the edges of the LA trunk section to the PFR on each side. Then, the middle of the skeletonized section of the PFR is pierced and the middle of the patch is leveled at the level of the PFR. The ends of the thread are connected, ensuring fixation of the PFR of the LA to the patch without narrowing the additional exit from the right ventricle. Then sew the edges of the patch with the edges of the cut of the right ventricle. In a particular case, the skeletonized department of the PFR and the patch are serially pierced twice to increase the reliability of the PFR fixation.EFFECT: method allows to prevent the development of pulmonary valve insufficiency, the development of right ventricular dysfunction by maintaining the integrity of the fibrotic pulmonary valve ring, the integrity of the pulmonary artery valve leaflets and, accordingly, their functions to ensure further growth of the pulmonary artery valve with preservation of its fun
