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

What is alleles, Whenever a pair of alleles has different alleles is there ...

Whenever a pair of alleles has different alleles is there dominance between them? Not in all cases of a gene having two different alleles is the dominance complete. There are g

What is vaso-constriction, a) What is 'vaso-constriction'? b) W...

a) What is 'vaso-constriction'? b) What are the effects of vaso-constriction in the skin?   a) Vaso-constriction is the reduce in diameter of small arterioles an

Define about selenoproteins p and w, Define about Selenoproteins P and W? ...

Define about Selenoproteins P and W? The third group comprises of selenoprotein P, an extracellular constituent with multiple selenocysteine molecules. This has an antioxidant

Explain the management of middle - third perforation, Explain the Managemen...

Explain the Management of Middle - Third Perforation Same to coronal one-third perforation, except defects located more deeper from the access cavity. For successfully

Transport through plasma membrane, TRANSPOR T THROUGH P.M. P.M. regula...

TRANSPOR T THROUGH P.M. P.M. regulates transport of materials in and outside of cell P.M. is semi- permeable as it allows rapid passage to water molecules. P.M. is selectively

Solitary and colonial forms, Solitary and Colonial Forms Animals may l...

Solitary and Colonial Forms Animals may lead their lives either like individuals or in groups. While they exist as individuals, they are termed as solitary, but if they live i

Spermatogonia - spermatozoa, Normal 0 false false false ...

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

Determine the significance of siphuncle., Determine the significance of Sip...

Determine the significance of Siphuncle. A cord of tissue that passes between different chambers of a Nautilid shell. Siphuncle regulates the amount of air or fluid in chambers

Are the xylem and the phloem made of living cells, Are the xylem and the ph...

Are the xylem and the phloem made of living cells? The cells that constitute the xylem ducts are dead cells killed by lignin deposition. The cells of the phloem are living

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