METHOD FOR HEART VALVE PROSTHESIS IMPLANTATION IN AORTAL POSITION

摘要

FIELD: medicine.;SUBSTANCE: pathologically altered aortic valve (AV) is dissected. The circumference of the fibrous ring (FR) of AV is divided into two semicircles, so that the middle of the first semicircle lies adjacent to the region of mitral-aortic contact. U-shaped stitches are applied along the first semicircle perimeter, puncturing both needles in from the ventricular, and out - from the aortic surface of AV FR. Next, U-shaped sutures are applied along the second semicircle perimeter. At that, both needles are punctured in from the aortic, and out - from the ventricular surface of AV FR. In the area of each boundary between the semicircles, a Z-shaped suture is applied. Parallel stitches of the Z-shaped suture are formed by passing needles through the AV FR similarly to the previously applied sutures. Then, the needles of all superimposed sutures are passed through the prosthesis cuff, beginning with its surface facing the ventricle. The prothesis is placed in the AV FR area, and the applied sutures are knotted.;EFFECT: method allows to reduce the number of complications caused by paraprosthetic fistula, coronary arteries overlapping by the prosthesis cuff of the with low position of coronary ostia, technical complexity of intervention under the conditions of small aortic window, and FR fusion due to the combination of supranualular and intranannular implantation techniques; to ensure the possibility of using prostheses with a large landing size by eliminating the rejection of larger diameter prostheses due to the impossibility of their location in the implantation area.;2 dwg, 1 ex