RETROGRADE PERFUSION OF THE PULMONARY ARTERY IN THE COMPREHENSIVE SURGICAL TREATMENT OF PULMONARY EMBOLISM

The study aims to analyze the results of retrograde perfusion of the pulmonary artery during open pulmonary thromboembolectomy in a group of patients with high and intermediate-high risk. Materials and methods. The study presents the practice of performing retrograde pulmonary artery perfusion following pulmonary embolectomy on 10 patients. The study describes technical equipment for surgery, which included a single-use system for injecting cold cardioplegia solution and two pumps of a heart-lung machine. The equipment was used for continuous intake of perfusate from the oxygenator tank and for intake of used combined protective solution, which was mixed during the surgery. The solution contained 800 ml of saline solution, 100 ml of 15 % mannitol solution, 400 ml of actovegin, as well as 12–16 ml of dexamethasone and was mixed with the blood perfusate at the ratio 3:1. It was injected into the pulmonary vein ostia under a pressure
of 15–20 mm Hg via its isolated cannulation with a 6–6.5 cm endotracheal tube, preliminarily connected with the system for retrograde perfusion. The injection was carried out for 4 minutes. Results. Despite the initial severity
of the patients’ condition, as well as the amount of surgical intervention performed, the hospital survival rate was 100 %. The proposed technique has demonstrated excellent clinical and hemodynamic results, neither specific
complications nor aggravation of the course of the intraoperative and early postoperative periods.

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