Explain arterial switch operation surgery, Biology

Assignment Help:

Explain Arterial Switch Operation Surgery?

This is the operation of choice for simple transposition of the great arteries as it ensures anatomical correction. The approach is through midline incision and median sternotomy. It is usually done with a high ascending aortic cannula and direct cannulation of SVC and IVC. Patient is cooled down to 18 to 25°C and pel-fusion flow reduced. There is no need for resorting to circulatory arrest.

Alternately, the operation could be done with single light atrial cannula and resorting to brief period of circulatory arrest. Heart is arrested by cold cardioplegic solution administered ante-grade through the aortic root. It could also be supplemented by retrograde cardioplegia through the coronary sinus.

The ductus is suture ligated and divided. Mobilisation of ascending aorta, inain and branch pulmonary arteries are done before cardio-pulmonary bypass. Large piece of pericardium is harvested and preserved for reconstruction of the pulmonary artery. The aorta is transacted above the coronary ostia. Pulmonary artery is transacted proximal to bifurcation. Coronary buttons are raised from their respective sinuses. They are re-implanted into the neo aorta, which was the previous pulmonary artery. A Le Compte manoeuvre is done by taking the pulmonary artery bifurcation anterior to the aorta. Two ends of the aorta are anastornosed - proximal pulmonary artery (neo aorta) to distal aortic segment.

PFO or ASD present is closed. At this stage the baby is rewarmed and aortic clamp released and heart allowed to beat. Right atrium is closed. Pulmonary artery is reconstiucted using two pericardial patches to fill up the sinuses from where coronary buttons were raised. Left atrial pressure monitoring line is inserted either through the appendage or through right superior Pulmonary vein.
Atrial and ventricular pacing wires are inserted.

Tran oesophageal echocardiogram will help in deciding adequacy of coronary circulation by assessing global and regional wall motion. The success of arterial switch operation depends on coronary arterial button transfer; which in turn varies according to the type of origin of coronary arteries in transposition of the great arteries.


Related Discussions:- Explain arterial switch operation surgery

Define the coenzyme activity of nicotinic acid, Define the Coenzyme activit...

Define the Coenzyme activity of nicotinic acid? Nicotinamide exists within the redox-active coenzymes,  nicotinamide adenine dinucleotide (NAD) and its phosphate (NADP), which

State the basic properties of light, Question 1 State the basic propert...

Question 1 State the basic properties of light. Discuss the special features of ultra-microscopy and phase contrast microscopy Question 2 What are ultrasonic waves.

How the blood sugar level is maintained at a stable level, Discuss how the ...

Discuss how the blood sugar level is maintained at a stable level in the well fed and fasting state In  the fed state, clearance of blood  glucose is mainly by  liver via gluc

How different are gymnosperms from bryophytes, How different are gymnosperm...

How different are gymnosperms from bryophytes and pteridophytes? Gymnosperms are not cryptogamic as bryophytes and pteridophytes are. They are phanerogamic and so they form flo

How are fishes characterized, Q. Fish identity card. How are fishes charact...

Q. Fish identity card. How are fishes characterized according to examples of representing beings, skin, basic morphology, circulation, nitrogen waste, respiration, thermal control

Poultry and duck diseases-avian reovirus infections, Avian reovirus infecti...

Avian reovirus infections There are several avian reoviuses isolated from chicken, turkey and other species of birds. They are associated with arthritis (tenosynovitis), respir

Explain procambium in primary growing shoot, Explain Procambium in primary ...

Explain Procambium in primary growth in shoot ? The vascular tissue in the shoot is produced from a primary tissue called the procambium, located in the apical meristem. New vas

What is digital periapical radiography, Q. What is Digital periapical radio...

Q. What is Digital periapical radiography? Digital radiographs can be subjected to image processing with which the images can be altered to achieve task specific image characte

Define nutritional requirements of fats and oils, Define Nutritional Requir...

Define Nutritional Requirements of Fats and Oils? As with the other macronutrients, we do compute requirements of visible fats too for all age groups and give guidelines for se

Write Your Message!

Captcha
Free Assignment Quote

Assured A++ Grade

Get guaranteed satisfaction & time on delivery in every assignment order you paid with us! We ensure premium quality solution document along with free turntin report!

All rights reserved! Copyrights ©2019-2020 ExpertsMind IT Educational Pvt Ltd