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

Evaluating the degree of urinary obstruction, Evaluating the degree of urin...

Evaluating the degree of urinary obstruction: D.P. is a 63-year-old man who has been experiencing progressive difficulty with initiating the urinary stream and frequently needs to

Explain light in cell metabolism, Explain Light in cell Metabolism? Ene...

Explain Light in cell Metabolism? Energy for almost all organisms on earth is derived directly or indirectly from light energy produced by the sun. Sunlight consists of energy

What is a terrestrial organism, Explain what is a terrestrial organism? ...

Explain what is a terrestrial organism? Ans) 'Terra' is the Latin word for earth. Thus, an animal that lives on the surface of the earth is known as terrestrial. This is the si

Anaerobic energy, how is the anaerobic energy system not entirely anaerobic...

how is the anaerobic energy system not entirely anaerobic?

Diabetic with hypertension, Kidney Disease   The target BP in chronic k...

Kidney Disease   The target BP in chronic kidney disease is set at 130/80.  This will retard the progression of renal function. The drugs recommended are the ACEI/ARBs. These c

What is the neurotransmitter of the neuromuscular junction, Q. What is the ...

Q. What is the neurotransmitter of the neuromuscular junction? How does the nervous system trigger muscle contraction? The nervous cells that trigger the muscle contraction are

Group and milieu psychotherapy, Group Psychotherapy:  Definition  ...

Group Psychotherapy:  Definition  Group psychotherapy  is a treatment of psychological problem in which two or more patients interact in the present of a psychotherapist.

Can pathophysiology causes cardiovascular disease, Q. Can Pathophysiology c...

Q. Can Pathophysiology causes cardiovascular disease? Cigarette use activates platelets, increases circulating fibrinogen, increases heart rate, and elevates blood pressure. It

Veins - circulation, Normal 0 false false false EN-IN ...

Normal 0 false false false EN-IN X-NONE X-NONE MicrosoftInternetExplorer4

How body size and composition affecting the bmr, How Body size and composit...

How Body size and composition affecting the BMR? Basal and resting energy expenditures are related to body size, being most closely correlated with the size of the fat-free mas

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