METHOD FOR REPLACEMENT ASCENDING AORTA AND AORTIC ARCH REPLACEMENT WITH REDUCING PROSTHESIS INTO TRUE LUMEN OF DISSECTED ASCENDING AORTA IN TYPE A DISSECTIONS

摘要

FIELD: medicine.;SUBSTANCE: right subclavian artery is approached and cannulated. A complete median sternal incision is performed. In the CB environment according to the schedule: a right subclavian artery - vena cava, at hypothermia to 26-28°C, selective antegrade cerebral, pharmaco-cold selective antegrade cardioplegia, an ascending aorta and its arch are longitudinally opened. A dissected intima is excised. Brachiocephalic branches are prepared for implantation into an arch prosthesis. The aorta is transected below an origin of a left subclavian artery within an isthmus, and the prosthesis 5-10 cm long in accordance with the diameter of the true lumen of the descending aorta is reduced into the true canal of the descending aorta. That is followed by forming a distal anastomosis between the ascending aorta and aortic arch prosthesis and the descending aorta by continuous locking stitch with a Teflon strip outside the aorta with the anastomosis area including a wall of the vascular prosthesis reduced into the true canal lumen of the descending aorta. The anastomosis is formed between the brachiocephalic branches and the aortic arch prosthesis. The ascending aorta is completely transected above the coronary artery beds; the proximal anastomosis of the prosthesis with the ascending aorta is formed.;EFFECT: method enables increasing the ease of inserting the prosthesis into the true canal of the descending aorta, eliminating a probability of the deformity of the inserted prosthesis by misaligned diameters of the prosthesis and aorta.;1 dwg, 2 ex