METHOD FOR PROSTHETIC AORTIC VALVE INSTALLATION WITH NARROW AORTIC VALVE FIBROUS RING

FIELD: medicine.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. After excision of the natural aortic valve, the fibrous ring is extended by a patch and the prosthesis is fixed in the supraannular position. A pear-shaped patch is formed. The width of the S patch near the blunt end is determined by the formula S=(DD)×π+8, where S is the width of the patch at a distance of F=L+(0.3-0.5 cm) from the blunt end, see; L is the length of the cut from the aortic valve fibrous ring to the base of the front mitral leaf, cm; Dis the original diameter of the aortic ring, cm; Dis the required diameter of the aortic ring, cm. 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 perform an adequate expansion of the fibrous aortic valve ring by implanting a prosthesis corresponding to the body surface area, while minimizing surgical aggression by excluding the opening of the left atrium dome.1 dwg, 1 tbl, 1 ex Изобретение относится к медицине, а именно к сердечно-сосудистой хирургии. Выполняют S-образный разрез аорты с переходом на фиброзное кольцо аортального клапана через вершину комиссуры между левой и некоронарной створками аортального клапана. Разрез продолжают в межклапанный фиброзный треугольник до основания передней створки митрального клапана. После иссечения естественного аортального клапана расширяют фиброзное кольцо заплатой и фиксируют протез в супрааннулярной позиции. Формируют заплату грушеобразной формы. Ширину S заплаты в области тупого конца определяют по формуле S=(D--D)×π+8, где S - ширина заплаты на расстоянии F=L+(0,3-0,5 см) от тупого конца, см; L - длина разреза от фиброзного кольца аортального клапана до основания передней митральной створки, см; D- исходный диаметр фиброзного