METHOD OF OPEN ENDARTERECTOMY IN DIFFUSE ATHEROSCLEROTIC INVOLVEMENT OF ANTERIOR INTERVENTRICULAR ARTERY

摘要

FIELD: medicine.;SUBSTANCE: method refers to medicine, namely to cardiovascular surgery. Performing an arteriotomy. It is prolonged along the whole length of the diffusively changed artery in the proximal and distal directions to the area suitable for the formation of an anastomosis with the condition that the pathfinder is passable in the distal one-third of the artery with diameter of not less than 1 mm, then atheromatous cast is circularly peeled with complete release of mouths of septal and diagonal branches. Further, the impression without tractions is cut off with scissors at angle of 45° with the condition of maintaining all layers of the artery wall in both the proximal and distal sections. After that, in case of insufficient length of left internal thoracic artery for direct anastomosis, to area of extended arteriotomy, first patch is inserted from autovein and then left internal thoracic artery is implanted into it. If the length of the left internal thoracic artery is sufficient, immediately after removal of the impression, an extended mammary coronary anastomosis of the shunt-plasty type is performed.;EFFECT: method enables increasing distal passage and preventing the risk of arterial thrombosis by completely removing intima remnants from its lumen and eliminating traction from the distal and proximal anterior interventricular artery, which prevents myocardial perfusion loss in the first septal branch with developing severe perioperative myocardial infarction, as well as providing regression of angina and predicted increase in duration and quality of life of patients due to use of auto-arterial graft.;1 cl, 12 dwg, 1 ex