METHOD FOR SURGICAL TREATMENT OF SECONDARY PULMONARY HYPERTENSION IN PATIENTS WITH MITRAL VALVE DISEASES

摘要

FIELD: medicine.SUBSTANCE: invention relates to medicine, namely to cardiovascular surgery, and relates to method of surgical treatment of secondary pulmonary hypertension in patients with mitral valve involvement in cardiac surgery. After median sternotomy, pulmonary artery trunk, bifurcation, initial sections of the right and left pulmonary arteries are isolated followed by circular exovasal sympathetic denervation with the radiofrequency electrode of the distal pulmonary trunk and the mouths of the right and left pulmonary arteries. Sympathetic denervation is carried out with a bipolar radio-frequency electrode containing two branches for transverse capture of the vessel. In this case they start from the distal pulmonary artery, then the electrode is displaced about 5–7 mm in the distal direction relative to the pulmonary artery and other radio-frequency applications are performed. Then the electrode is transferred to the initial section of the left pulmonary artery mouth, it is performed with the same number of RF applications, and then performs the same radio-frequency applications on the right pulmonary artery. Each application is executed three times with a frequency of 460 kHz, with a maximum output power in the range from 22.8 W to 28.5 W for 20–40 seconds.EFFECT: method allows to increase efficiency of surgical treatment of cardiosurgical patients with high pulmonary hypertension against the background of mitral valve pathology due to the additional performance of radiofrequency ablation of the pulmonary trunk and the mouths of the pulmonary arteries, which contributes to a significant decrease in the degree of pulmonary hypertension in the postoperative period.1 cl, 6 dwg, 2 ex