METHOD FOR ELIMINATING TYPICAL ATRIAL FLUTTER WHEN PERFORMING THORACOSCOPIC OPERATIONS AIMED AT TREATING ATRIAL FIBRILLATION

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, particularly to cardiovascular surgery. Guide director is inserted into the pericardial cavity along the diaphragmal heart surface anterior from the inferior vena cava. Ablation device is positioned so that its ends in area of their connection with guide directors are located at the level of right pulmonary vein mouths. Jaws of the ablation device is directed to the area of the Waterston furrow and the adjoining wall of the right atrium by arched side. Jaws of the ablation device grasp the wall of the right atrium together with the epicardial cellular membrane of the Waterston furrow. Fenestrated forceps are used to grip and pull a wall of the right atrium into the space between open jaws of the ablation device. Radio-frequency exposure is applied. Transmittance damage is achieved. Ablation device is removed from right pleural cavity. Ends of ablation device are disconnected from Guide directors located in transverse and oblique sinuses of pericardium. Ends of the ablation device are connected to a guide director positioned in an oblique sinus of the pericardium posterior to the inferior vena cava, and with a guide director located along the diaphragmal heart surface anterior to the inferior vena cava. Concave part of the jaws of the ablation device is directed towards the diaphragm. Then, guide directors are used to grip myocardium of right atrium with jaws of ablation device. Grip line is 1–2 cm distal to the inferior vena cava mouth; radio-frequency exposure is applied. Transmurality of damage is achieved.;EFFECT: method enables eliminating typical atrial flutter when performing thoracoscopic operations aimed at treating atrial fibrillation, reducing the number of postoperative complications in the form of supraventricular arrhythmias, besides, there is no need for a second stage of surgical management – in endovascular destruction of the cava-tricuspid neck.;1 cl, 1 ex