GOSUDARSTVENNOE OBRAZOVATELNOE UCHREZHDENIE VYSSHEGO PROFESSIONALNOGO OBRAZOVANIJA "KRASNOJARSKIJGOSUDARSTVENNYJ MEDITSINSKIJ UNIVERSITET IMENI PROFESSORA V.F. VOJNO-JASENETSKOGO MINISTERSTVA ZDRAVOOK
发明人:
ZALEVSKIJ ANATOLIJ ANTONOVICH,Залевский Анатолий Антонович,SAMOTESOV PAVEL AFANASEVICH,Самотесов Павел Афанасьевич,KRIVOPALOV VLADIMIR ALEKSANDROVICH,Кривопалов Владимир Александрович,KAPTJUK GEORGIJ
申请号：
RU2011131345/14
公开号：
RU0002467703C1
申请日:
2011.07.26
申请国别(地区):
RU
年份:
2012
代理人:
摘要：
FIELD: medicine.SUBSTANCE: invention refers to medicine, namely cardiosurgery, and can find application in surgeries of prosthetic repair of aneurisms of the entire thoracic aorta. Substance of the method consists in intercostal thoracotomy and transverse incision of sternum. The sternal edges are at 1.0 cm at the level of I intercostal space. Investing tissues, pectoral fascia and presternum are incised by counter incisions inclined at 20-30 degrees to a horizontal line. The investing tissues are incised along a left border of mesosternum. Ends of II-V ribs are separated therefrom, and anterior mediastinum is exposed. Pleural fold is incised and pleural cavity is exposed. In V intercostal space, internal thoracic vessels are ligated and transected, intercostal thoracotomy is performed to left posterior axillary line. Intercostal wound edges are opened with a dilator. Sternal rib ends separated from sternum together with attached greater pectoral muscle bundles are dislocated towards I rib and brought entoectad by another dilator. A lower fragment of the incised sternum is brought inwards. From the pleural cavity, left diaphragm nerve is separated from pericardium. A diaphragm portion of pericardium is separated from diaphragm to a right-side seam. Lung and heart apex are antepositioned. That is followed by exposure of all portions of thoracic aorta so that to create vascular anastomoses. Closure of the incisional wound is preceded by drainage of anterior mediastinum, pericardium cavity, and left pleural cavity. The wound along the sternum is closed by edges of periosteum, pectoral fascia and tendon elements of sternocostal joint capsules. Sternum is repaired by through interrupted sutures.EFFECT: use of the given invention allows minimising a sternal injury at the stage of the surgical approach to thoracic aorta and a probability of developing sternal osteomyelitis and anterior purulent mediastinitis in the remote postoperative period, improving parameters of the i
