SU1528459A1 - Method of treatment of dissecting aneurysm - Google Patents

Abstract

This invention relates to medicine, namely to vascular surgery. In order to strengthen the distal anastomosis, the inverted vascular prosthesis is immersed into the lumen of the distal aortic stump formed after resection of the aneurysm, sutured the edges of the prosthesis and all layers of the aorta, simultaneously gripping the seam and two Teflon strips located between the detached intima and the outer wall of the aorta and outside the aorta. Then the prosthesis is inverted and anastomosis is applied with the proximal aortic stump. Intra- and postoperative complications are not. 4 il.

Description

This invention relates to medicine, in particular to vascular surgery.

The aim of the invention is to strengthen the distal anastomosis by using teflon liners between the layers of the aorta and simultaneously suturing the false aortic lumen and the anastomosis.

FIG. 1-4 are stages of the process.

Example. Volnaya Ya., 34 years old, diagnosed with Marfan syndrome, dissecting aneurysm of the descending thoracic aorta, SB type retrograde dissection of the aortic arch and ascending thoracic aorta. Aortic fenestration is localized in the descending aorta distal to the left subclavian artery.

The aneurysm segment was resected along with fenestration. It was noted that the separation of the aortic wall both in the distal direction and in the proximal direction was thinned, loose. The same pattern was observed in the subclavian artery, the walls of which are also exfoliated. A vascular prosthesis with a diameter of 18 mm turned inside out is laid in the true lumen of the distal aorta. Strips of Teflon felt 1 cm wide are laid into the false clearance along the edge of the detached intima and along the entire outer circumference (Fig. 1). With one suture, Prolene 3-0 is simultaneously stitched together with a vascular prosthesis (1) of the intima, an internal teflon strip (2), a peeled aortic wall and an external teflon strip (2) (Fig. 2). At the same time, the false lumen is sutured and the distal anastomosis is superimposed. Then, the x-prosthesis is turned out from the lumen of the aorta (Fig. 3) and a proximal anastomosis of the prosthesis with the proximal aorta (Fig. 4) is applied. At the same time, a strip of teflon was inserted into the proximal anastomosis, as well as in the lumen of the lumen, which was gripped in the seam. Then a prosthetic procedure was made

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In this case, the subclavian artery, along with the dissected artery walls, was an ulazhep teflon felt in the form of a strip 1 cm wide. After starting the blood flow, all three anastomosis of the prosthesis with the aorta and artery were sealed. There were no hemorrhagic complications either during the operation or in the postoperative period (more than 1 month).

According to x-ray and ultrasound methods, the function of the prosthesis is satisfactory.

Claims (1)

Invention Formula A method of treating a dissecting aneurysm by resection of the aneurysm. replacing the aorta area with a prosthesis with anastomotic overlay, characterized in that, in order to strengthen the distal anastomosis, the vascular prosthesis with the inner side is immersed against the inner wall of the distal aortic stump, between the detached intima and the outer wall of the aorta, one teflon strip and another teflon strip placed outside the aorta, pressing the prosthesis, all layers of the aorta with Teflon strips, seizing them together in one suture, after which the free end of the prosthesis is removed from the aorta, and then anastomosis of the prosthesis is performed. roximal end. FIG. 2 Fi.Z fie. k