MOSCOW, April 17. /TASS/. Specialists from the S. M. Kirov Military Medical Academy have patented a new method for removing metal fragments from the heart muscle while the heart is still beating, without the use of a heart-lung machine, according to the corresponding document, a copy of which TASS has obtained.
According to the patent description, the new technique is intended to replace the traditional approach, which requires stopping the heart, connecting the patient to a heart-lung machine, systemic heparinization, and prolonged cardiac resuscitation.
"The heart is accessed via a sternotomy or thoracotomy. The pericardium (heart sac) is opened in a T-shape, and the pericardial layers are secured with holders. The heart, pericardium, and great vessels are inspected for entry wounds, the wound channel, and the trajectory of the foreign body. If the splinters are located superficially, their precise localization is ensured by a neodymium magnet placed in a 1/4-inch silicone tube for ease of use and sterilization. If the foreign body penetrates deeper into the myocardium, it can be located by intraoperative fluoroscopy," the document states.
Next, the area of the heart containing the splinter is stabilized using a myocardial vacuum stabilizer. To prevent excessive bleeding during removal, a provisional U-shaped suture on Teflon pads or a purse-string suture is placed in the projection of the fragment.
"A scalpel is used to make an incision in the myocardium above the fragment, the size of the incision being chosen depending on the fragment’s size. The fragment is removed through the incision using a neodymium magnet. The fragment’s bed is treated with a betadine solution. The incision edges are brought together using a previously placed suture, ensuring hemostasis. The wound is then sutured layer by layer," the patent authors state.
They note that two such surgeries have already been performed, with patients showing good results post-operation. "The authors’ proposed surgical technique for gunshot wounds to the heart is aimed at minimizing the use of artificial circulation in order to shorten the duration of the surgery, reduce blood loss, and reduce pain, thereby avoiding unnecessary financial costs," says the patent description.