METHOD FOR HYBRID TREATMENT OF AORTIC ANEURYSM WITHOUT ARTIFICIAL CIRCULATION WITH MAINTAINING PERFUSION OF CEREBRUM DURING TRANSPOSITION OF BRANCHES OF AORTIC ARCH
Shlomin Vladimir Vladimirovich (RU),Шломин Владимир Владимирович (RU),Bondarenko Pavel Borisovich (RU),Бондаренко Павел Борисович (RU),Puzdryak Petr Dmitrievich (RU),Пуздряк Петр Дмитриевич (RU),Gusin
申请号：
RU2019108904
公开号：
RU0002716453C1
申请日:
2019.03.27
申请国别(地区):
RU
年份:
2020
代理人:
摘要：
FIELD: medicine.SUBSTANCE: invention relates to medicine, in particular, to cardiovascular surgery. Transposition of the brachiocephalic trunk is performed with preserving cerebral perfusion by means of a temporary shunt. Temporary shunt proceeds and tightly fixed to the distal end of the right branch of the bifurcation synthetic prosthesis and is passed into the lumen of the dissected brachiocephalic trunk through a transverse incision in the distal end of the left branch. End-to-end anastomosis is formed between the brachiocephalic trunk and the left branch of the bifurcation prosthesis. Temporary shunt is removed from the lumens of a brachiocephalic trunk and a left branch with restoration of its tightness by a pre-applied purse-string suture with restoration of blood flow along the right internal carotid and subclavian arteries. After that, using the right branch blood flow is sequentially switched to the left common carotid and left subclavian arteries. That is followed by a layer-by-layer closure of the wound and subsequent stent-graft implantation into the ascending, arch and thoracic aorta.EFFECT: method enables reducing the time of cerebral ischemia by maintaining adequate arterial pressure and blood flow in the brachiocephalic arterial system when transposing into a vascular prosthesis and reducing a risk of the intraoperative complication in the form of ischemic stroke on the side of carotid artery clamping.1 cl, 1 ex, 11 dwgИзобретение относится к медицине, в частности к сердечно-сосудистой хирургии. Выполняют транспозицию брахиоцефального ствола с сохранением перфузии головного мозга с помощью временного шунта. При этом временный шунт исходит и герметично фиксирован к дистальному концу правой бранши бифуркационного синтетического протеза и проведен в просвет отсеченного брахиоцефального ствола через поперечный разрез в дистальном конце левой бранши. Затем формируют анастомоз «конец в конец» между брахиоцефальным стволом и левой браншей бифуркационного п
