SU1685414A1 - Method for thrombectomy from the left cardiac atrium - Google Patents

Abstract

This invention relates to medicine, namely cardiovascular surgery, and can be used in the surgical treatment of complicated mitral heart disease. The purpose of the invention is to reduce the number of postoperative thromboembolism. The purpose of the invention is achieved by invaginating the left atrial appendage, fixing it around the perimeter of the atrium thrombotic pad, and the area of action is pre-isolated with balloons that are installed in both the left atrioventricular orifice and pulmonary veins. The method allows to reduce the number of postoperative thromboembolism from the left atrium.

Description

WITH

with

This invention relates to medicine, namely cardiovascular surgery. The purpose of the invention is to reduce the number of postoperative thromboembolism.

The method of thrombectomy from the left atrium is carried out as follows.

The cavity of the left atrium from the pulmonary veins and the cavity of the left ventricle is isolated from specially prepared soft rubber balloons. A large rubber balloon is conducted into the cavity of the left ventricle. The balloon is filled with cold saline solution, tightened and fixedly fixed in the mitral orifice. Similarly, small rubber balloons are introduced into the pulmonary veins through their mouth, filled with cold saline, tightened and rigidly fixed. The thrombotic masses of the atria are removed with a spoon and end clamps. The thrombotic pad is left. Thoroughly revise the cavity of the left atrium and remove all visible particles of thrombotic masses. Then, the cavity of the left atrium is washed several times with cold saline, which is removed by an ejection. After thrombectomy, the balloons are removed. The left ear of the heart is invaded into the cavity of the left atrium. An invaginated ear covers the thrombotic site. The free edges of the abalone are fixed to the endocardium of the left atrium with a continuous back-up seam with propenoby thread No. 144/0.

Example. Ill 3., 46 years old. Diagnosis: rheumatism, inactive phase. Mitral pore of the heart with a predominance of stenosis. Calcina valve flaps ill degree. Thrombosis of the left atrium. Atrial fibrillation. Circulatory insufficiency, PB degree, IY functional class by the classification of the New York Association

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cardiologists. After pgjus hs. rational iu roiOEiKM 123. Pred-: 198G, the patient was suffering from the heart of the heart of the median cicpiiO C in Lg parag and from the state of kroio; - And. General Practices of the General Organization of the Operations: • Shred the foam in the following conditions: Sy young DO & M (I-) i3 - Makolop. Scap.Zrd; //: - -, His Himself, Mitral clan: Implements riy: C - opening of the atrial area of the icx atrium of the right atrial groove H.JH revi .- / cavity of the left atrium drilled rpo.vij, occupying the left ai.rr reddrss | M M. chral loidiiaH deform oa and the folds spliced along the skin of the surams. Mg hole diag eeom 15 mCH In the region of the medial kgm of the syringe. , cjrij qi, spread HI-yuu with on fibres with ring clamps. In the south, i8s: rj ventricular through o; gerst / e vze, aZg: large pejiiH03bi 7 bslpsi. The balloon through the catheter sepolie; / Long-term physiologists SR UHMM in orpmema 26 hg / shoulder-o is fixed with mitral ile ever-gki. The pulmonary vems were injected with the resuspicious flashes and the fixation was fixed at the post of fillings with 3 ml in the mouth of the pulmonary veins. Slug Udegen lokoy and the end clip. Thrombotic; 5; area-about area 5 rh-- pgs11o; hZlag on the left of the mouth:, its lppoch.1: gene, small mag- noses of the thrombus r 1hce k.) 1 caco removed At the iyrc-i flushing of the atrial cavity atrial cold phase of the lymph 7g1 with 1m solution in the amount of 2000 ml, VA r ievero not Left yiiiKo sickle ;; in ap / chnirovachno in the left prederdm (rasun to filed. you to the endocchr lezego predserd - vzz g thrombotic ptnadk i reprogramm obvivivshim sheom POFNOEnoy hfe 14 4/0. fragmeigi ilccium ivccc removed putgs / flashing polgsmmogs

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a solution in the amount of 2000ml removed for release. After flushing the left atrium, the cylinders are removed. Chords and papillaries were excised. 3 moral position (iplant / .rov) disk prosthesis Zmiks M11I-29 Psspe of the left atrium for blood closure of the heart chamber. The heart rate was restored by the dzf-bril l torus discharge.

Postoperative periid was uneventful. Out of 26 out. Then the operation is sick. ”: home. In the case of homologous study of the southern rmba: the mass of the thrombus is 70 g. Gsib is mixed. With

next king & son / exploring in november 1988, sststs ns Strongly successful. Dyspnea and palpitations are not. After the operation, a laser produces a significant nafuzka, a slave of an operative of an engine room with a sonkhsze. X-ray examination of the heart decreased with. sizes, norpalized pulmonary pattern. According to this method, 17 patients were operated on. Complications and fatal outcomes in the early postoperative period were not. The term of observation of patients is from 8 months. about 6. Complications and lethal long-term follow-up

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application

Formula i / z gbrete e R Method of thrombosis; 1y from the left atrium, the key is a common ear pin

auricle about tl; " but ; and, with the goal of reducing Miic and thromboembolism, the left ventricular luvc invaginates n (h.p.

that the range of action is insulated by ballons that are placed in the left atrioventricular hole and the mouth of the lung iwx foams

Claims (1)

Forms at La Czapenani I A method of thromboectomy from the left atrium, including ligation of the left atrial abdominal ligament, is that in order to reduce the number of postoperative thromboembolism, the left atrial lobe is invaginated and fixed along the perimeter of the thrombotic site, while the area of action is preliminarily isolate with cylinders, which set the 8 left atrioventricular opening and the mouth of the pulmonary veins. cardiologists. After the preoperative preparation on April 23, 1936, the patient was operated on. Access to the heart through the median sherstom. The apparatus of an artificial cro-oobr-gshchag and I connected to 5 conventional methods. The operation was performed under conditions of external cold and pharmacological cardioplegia. The mitral valve is accessed by the chickpea opening of the left atrium behind the atrial sulcus on the right. During the auditory cavity atrium revealed a thrombus, occupying the left side of the atrium. The mitral valve is deformed. Sashes fused to gy commissures. Miterzl-15 aperture with a diameter of 15 mm gapes. 3 areas of medial commissure are a block of calcium extending to the fibrous ring of the valve. A large rubber bzlsi was introduced into the left ventricle through the mitral opening. The balloon through the catheter is filled with cold saline in a volume of 26 ml and tightly fixed in the mitral orifice. Small rubber bellons were introduced into the pulmonary veins and fixed after filling 3 ml in the mouths of the pulmonary veins. The thrombus is removed with a spoon and a terminal clamp. Thrombotic area; , 5 cm was located to the left of the mouths of the pulmonary veins. Small particles of thrombotic masses were removed by washing the left atrial cavity with cold saline in an amount of 2000 ml, which was removed for ejection. The left ear of the heart is unaggregated in 3-5 positions of the left atrium. The edges of the abalone are sutured to the endocardium of the cautious atrium around the thrombotic p and o. cadet and are continuous in the upholstered suture with suture thread No. 14 4/0. The valves of the mitral valve are excised 40. Separate fragments of calcium masses were removed by washing the cavity of the atrium of the atrium with a single lobe and a physiological membrane.