RU20235U1 - VALVE CONDITION FOR PROSTHETICS OF THE RISING AORTA - Google Patents

Abstract

A valve-containing conduit for ascending aortic prosthetics containing a plate partially sewn at the base, forming a tube, and a biological valve prosthesis fixed at the base of the tube, characterized in that the plate consists of two layers: an inner one made of a glisson liver capsule and an outer one from synthetic material glued together with biological glue, and sewn with a continuous twisting seam at the base for 15-20 mm, forming a tube with a diameter of 20-30 mm, and to the proximal section of the tube dshit "end-to-end" porcine aortic valve of the appropriate size.

Description

The utility model relates to medicine, namely to cardiac surgery.

Surgical treatment of ascending aortic aneurysms is one of the urgent problems of modern cardiac surgery. Despite the successes achieved, the dissatisfaction of the surgeons in the use of conduits from synthetic tissues (bleeding, rigidity, difficulty in applying anastomoses) and various types of biological prostheses (calcification, tears) remains. This involves further active research and the search for new materials.

Known xenopericardial valve-like conduit used in prosthetic ascending aorta (Malashchenkov A.I., Fursov B.A., Rusanov N.I. et al. Clinical use of xenopericardial conduits in surgery for ascending aortic aneurysms. Thoracic and cardiovascular surgery, 1993, 5, 50-53.). This prosthesis is a partially formed xenopericardium cylinder with an implanted bioprosthesis from a similar tissue. In the proximal part, the xepericardial tube was sutured with a double-row continuous suture only to the height of the bioprosthesis strut, and its base was fixed with a continuous suture to the protuar cuff.

The disadvantage of this conduit is the rapid degeneration of the wall of the conduit, its valve with the development of calcification and subsequent dysfunction. In the separated time after the operation, aneurysmal expansion and rupture of the conduit in places of thinning of its wall are possible.

The objective of the utility model is to increase the life of the prosthesis.

The task is achieved by whose conduit is a plate consisting of two layers: the inner, made of a glisson capsule of the liver and the outer, made of synthetic material (dacron), glued together with a biological glue, sewn continuously

a twisted seam in the form of a tube and the end-to-end sweep of the aortic valve of the appropriate size is hemmed to the proximal part of the tube.

A general view of the valve-containing conduit for prosthetics of the ascending aorta is shown in FIG. 1.

The valve-containing conduit for prosthetics of the ascending aorta 1 consists of two wide plates: a glisson capsule of the liver 2 and synthetic material (dacron) 3. Both plates are glued together with biological adhesive 4, sewn with a double-row (entwined) suture 5 in the proximal section for 15-20 mm and they are a partially formed tube 6 with a diameter of 20 to 30 mm, moreover, a plate of a glisson liver capsule 2 is located inside the tube 6, and artificial material (dacron) 3 is outside the tube 6. At the base of the conduit 1 (proximal part) end-to-end 7 implanted pig aortic valve 8 of the appropriate size. Sterilization and storage of conduit is carried out in a solution of glutaraldehyde by a known method. Before the operation, the conduit must be washed three times in saline from the preservative and periodically moistened with saline during the operation.

An example of a specific implementation.

Pre-glue the biological mask with glue 4 plates of a glisson capsule of the liver 2 and synthetic material (dacron) Z of size 100; 120 mm. After the glue has dried, a tube 6 is formed, and the plate from the glisson capsule of the liver 2 should be inside the conduit 1. The proximal part of the tube 6 is sutured with a continuous twisting seam 5 over 20 mm. A pork aortic valve 8 with a diameter of 28 mm fixed in glutaraldehyde is sutured to the proximal conduit 1 of the end-to-end type 7.

Conduit implantation is performed according to a standard technique. At first they fully adapt the conduit, i.e. measure the required length, excise excess tissue, if necessary, sew the edges of the side seam of the combined conduit. After the start of cardiopulmonary bypass, the aorta is opened, the aortic valve is excised, a conduit proximal anastomosis with the base of the aorta is applied, then a distal anastomosis with an aortic arch.

manufacturing, storage, preparation for use. Conduit implantation techniques are standard. This conduit can be used in the clinic for the correction of ascending aortic aneurysms, acquired heart defects, complex congenital heart defects.

Claims (1)

A valve-containing conduit for ascending aortic prosthetics containing a plate partially sewn at the base, forming a tube, and a biological valve prosthesis fixed at the base of the tube, characterized in that the plate consists of two layers: an inner one made of a glisson liver capsule and an outer one from synthetic material glued together with biological glue, and sewn with a continuous twisting seam at the base for 15-20 mm, forming a tube with a diameter of 20-30 mm, and to the proximal section of the tube dshit "end-to-end" porcine aortic valve of the appropriate size.