METHOD OF IMPLANTATION OF CARCAL PROSTHESIS OF HEART VALVES IN AORTAL POSITION WITH ONE-MENT PROSTHETICS OF MITRAL AND AORTAL VALVES

摘要

FIELD: medicine.;SUBSTANCE: dissecting the natural aortic and mitral valves and implanting the mitral valve prosthesis. SUBSTANCE: s-shaped incision of the aorta is performed with a transition to the fibrous ring through the commissure top of the aortic valve between the left and non-coronary aortic valve leafs. The incision is continued to the base of the front leaf of the mitral valve to the inter-valve fibrous triangle. Expanding the fibrous ring with a patch and fix the prosthesis of the aortic valve in the supranannular position. A pear-shaped patch is formed. The width S of the patch in the region of the blunt end is determined by the formula: S=(D2-D1) 8, where: S (cm) is the width of the patch at a distance of F (cm) = L+(0.3-0.5 cm) From the blunt end; L (cm) is the length of the incision from the fibrous ring of the aortic valve to the base of the anterior mitral valve; D1 (Cm) - the initial diameter of the fibrous aortic ring; D2 (Cm) is the required diameter of the fibrous aortic ring. Patch blunt end is fixed in the cut by a continuous suture. The prosthesis is fixed using separate U-shaped seams, passing the threads from the bottom to the top. The threads of the superimposed sutures are directed through the cuff of the prosthesis using 2/3-3/4 of the cuff diameter. The remaining part of the cuff is stitched with U-shaped sutures, the threads of which are passed through the patch from the inner side to the outside and then through the common felt pad. Patch fixation in the cut is finished. The remaining aortic incision is sutured.;EFFECT: method allows to adequately expand the fibrous ring of the aortic valve due to the patch used, by implanting a prosthesis corresponding to the body surface area of ​​the patient, minimizing surgical aggression by excluding the opening of the left atrium dome, ensuring the possibility of combined prosthetic repair of the mitral and aortic valves.;1 tbl, 1 ex, 1 dwg