METHOD FOR FORMING A DISTAL ANASTOMOSIS IN RECONSTRUCTION OF RIGHT VENTRICULAR EXIT SITES BY EXTRACARDYAL CONDUIT IN CHILDREN WITH CONGENITAL HEART DISEASES ACCOMPANIED BY ORAL STENOSIS OF THE RIGHT OR LEFT PULMONARY ARTERY

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to cardiosurgery. When the distal anastomosis is formed during the reconstruction of the right ventricular exit site with an extracardiac conduit in children with congenital heart defects accompanied by stenosis of right or left pulmonary artery mouth, connect bifurcation are of the pulmonary trunk and one of conduit ends. On one of the conduit anastomosed end walls, longitudinal section is made, and then a cross-section equal to ¼ perimeter of conduit. Segment obtained at conduit end is turned away from the conduit, giving it letter "T" form, and to the opposite, remaining part of conduit end wall is modeled, cutting off from it a part corresponding to isosceles rectangular triangle shape, one of the legs of which is the edge of the longitudinal section, and the second one is located along the edge of the conduit. Section s made through pulmonary trunk bifurcation area with transition towards narrowed pulmonary artery side to its lobar branches mouths. Conduit is oriented in such a way that divergent segment – letter "T" flat part – coincide with length of completed vascular incision, and sew conduit in this section.;EFFECT: method makes possible to achieve an expansion of the lumen of right or left pulmonary artery at the expense of the segment in their estuarial stenosis without use of additional plastic materials; and also excludes two-dimensional circular closure of anastomosis line, which prevents conduit dysfunction in distal stenosis development in long-term postoperative period.;4 cl, 1 ex, 5 dwg