Список литературы

2687-0940

Challenges in modern medicine

2687-0940

10.52575/2687-0940-2021-44-4-437-449

SURGERY

<strong>A new method of posterior plasty of the aortic root and left ventricular outflow tract for implantation of a larger prosthesis into the aortic position</strong>

Sazonenkov

Maksim A.

Sazonenkov

Maksim A.

sazonenkov@mail.ru

Ismatov

Hushbahtdzhon H.

Ismatov

Hushbahtdzhon H.

Tatarintsev

Andrey M.

Tatarintsev

Andrey M.

Moskalev

Andrey S.

Moskalev

Andrey S.

2021

44400

Successful aortic stenosis treatment depends on the corresponding prosthesis size implantation. Valve effective orifice index by S. Rashimtoola must exceed 0.85. In many cases the initially small annulus requires aortic root patch plasty. The aortoplasty frequency for the 21 and rarely 23 valve sizes is about 15–42 %. In adults the most often two methods are used. Incision of the posterior aortic wall and mitral-aortic curtain (M-A curtain) is the Nicks R. (1970) technic. The same maneuvers with incision prolongation on mitral valve anterior leaflet (MVAL) is the Manouguian S, Seybold-Epting W. (1979) technic. However, in the cases of advanced deforming aortic stenosis the M-A curtain and MVAL transection with patch implantation seems to be critically dangerous. In this circumstances it is possible to change the incision direction to the right muscular trigone of the left ventricle outflow tract (LVOT). The literature review, anatomic specimens research, our practice of valve-sparing aortic root replacements and number of posterior aortoplasty technics revealed that manipulations in LVOT muscular trigones were not very dangerous. During period 01.01.2015–01.08.2021 in the Cardiac Surgery Department of Belgorod regional clinic there were 35 cases of posterior aortoplasty. Of them the aortoplasty with right muscular trigone incision constituted 4 cases. In all aortoplasty technics we didn’t have problems with hemostasis or A-V pathway lesion. Our practice of David T.E. operation, number of posterior aortoplasty technics, aortoplasty with right muscular trigone incision showed small hemorrhage and A-V pathway lesion risks. Posterior aortoplasty with right muscular trigone incision may be used in cases of small aortic annulus with M-A curtain and MVAL calcinosis.

ascending aorta and left ventricle outflow tract anatomyposterior aortoplasty in adultaortic valve replacement

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