METHOD FOR SURGICAL TREATMENT OF ATRIAL FIBRILLATION DURING MITRAL VALVE REPLACEMENT IN CONDITIONS OF ARTIFICIAL BLOOD CIRCULATION

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, to the field of cardiovascular surgery. The patient is connected to an artificial blood circulation apparatus. Cardioplegia is performed, the left atrium is opened, the cavities of the left atrium and the entries of the pulmonary veins are exsanguinated. The myocardium of the left atrium: the posterior wall of the left atrium and the left atrial appendage, and the entries of the pulmonary veins, are isolated. Radiofrequency ablation is performed, wherein isolation lines leading to the mitral isthmus, trigger area isolation lines, lines for isolation of the entries of the left and right pulmonary veins are applied, the entry of the pulmonary veins outside of the myocardium is circled with mylar tape. A bipolar clamp is applied and power is applied 3 times onto one area, the branches of the bipolar clamp are shifted 3 mm from the initial line for isolation of the entries of the pulmonary veins, radiofrequency ablation is performed 3 times with the bipolar clamp. The mitral valve is replaced, annuloplasty of the tricuspid valve is performed. The right atrium is sutured. Left and right heart deembolisation is performed. Electrodes are sutured to the endocardium of the right atrium and the right ventricle. Artificial blood circulation is stopped. The wound is sutured in layers.;EFFECT: method provides a possibility of performing simultaneous isolation of the foci of trigger areas and sources of macroreentry generation in the left atrium, as well as preventing further dilation of the annulus fibrosus of the tricuspid valve and dilation of the cardiac chambers, thus minimising the risk of repeat valve dysfunction, repeat atrial fibrillation rhythm, and reducing the risk of implantation of permanent antiarrhythmic apparatuses; achieving preservation and long-term recovery of the sinus rhythm, and the mitral valve replacement and correction of the tricuspid disease normalises the intracardiac heart hemodynamics, thus forming the physical well-being of the patient for a long period of time.;1 cl, 3 dwg, 1 ex