Explain the techniques of surgical correction , Biology

Assignment Help:

Explain  the Techniques of Surgical Correction ?

Techniques of Surgical Correction proximal Dissection (De Bakey type I and IZ or Stanford A)

Monitoring lines are inserted in the right radial and left femoral arteries. TEE and Doppler of carotid artery will be very helpful. The light common femoral artery is exposed by a vertical incision. If there is dissection in hat, the channel through which there is forward flow is cannulated for arterial return. At times it may lead to obstruction of retrograde pel-fusion and so provision is made for cannulation of the ascending aorta, aortic arch, axillary artery or left ventricular apex. For CP bypass a venous cannula is passed to right atrium through right femoral vein. After median sternotomy and pericardiotomy cannulation of both venas cavae are done. If only the ascending aorta needs replacement, circulatory arrest is not required. Heart is vented through right superior pulmonary vein. A retrograde coronary sinus cannula is passed for cardioplegia administration. Aorta is clamped proximal to innominate artery and opened vertically. First opening is into the false lumen, which may contain clots. Intimal tear and true channel are visualised. This is opened and by direct cannulation of coronary ostia antegrade cardioplegia is given. Then aorta is transacted 4 to 5 cms above the aortic annulus. If dissection has extended to the annulus it can be fixed by interrupted 4 '0' prolene sutures. If coronary ostia are involved they can be raised as buttons with aortic wall and repaired with fine prolene sutures and then re-implanted into the ascending aortic graft. If dissection deep into coronaries exists, coronary artery bypass is indicated.

Two thin strips of PTFE or Dacron graft or pericardium - one inside and one outside the aorta are placed and interrupted sutures are taken through both strips and both layers of dissected aorta. The end of collagen impregnated Dacron graft is sutured to the newly created aortic cuff. Alternatively GRF (gelatin resorcinol formaldehyde) glue may be used between the two layers of dissected aorta and then graft anastomosed to its end. If the aortic valve is abnormal, a composite valve and graft (Bental procedure) will have to be done. In case of De Bakey type II dissection the aorta is transected below the clamp and innominate artery. End of the tube graft is then anastomosed to the cuff using thin strips of PTFE or gluteraldehyde treated pericardium 'for reinforcement. Alternatively, GRF glue can be used for sticking the two layers of dissection and the anastomosis to the graft done last. De-airing is done before removing the aortic clamp and heart is allowed to beat.


Related Discussions:- Explain the techniques of surgical correction

Plant water, Plant Water Role of Water in Plants You know that water i...

Plant Water Role of Water in Plants You know that water is the main constituent of plant cells. It performs the following major functions Water as a Solvent Water is a v

PLASMODIUM LIFE CYCLE, elucidate a life cycle of a plasmodium that causes m...

elucidate a life cycle of a plasmodium that causes malaria

What is difference between the beta and the alpha-protien, Q. What is the d...

Q. What is the difference between the beta-sheet and the alpha-helix protein conformations? Beta-sheet and Alpha-helix conformations are the two main types of secondary structu

Define the term - functional magnetic resonance imaging, Define the term - ...

Define the term - Functional magnetic resonance imaging Functional magnetic resonance imaging (fMRI) is a recent development that permits simultaneous measurements of the brain

Equipment of circulatory assist devices, Equipment :  Basically, it has an...

Equipment :  Basically, it has an intra aortic balloon pump. A balloon with a capacity of 40 ml is passed percutaneously through the femoral artery up to the upper end of descen

Hiv, The chances of transmission in female is mor than males

The chances of transmission in female is mor than males

Determine the antagonist of the glycine receptor, Person Z swallowed a larg...

Person Z swallowed a large amount of substance X and, as a result, has convulsions (abnormal violent contractions of skeletal muscles).  Swallowing which of the following substance

Micronutrients in food, Vitamins Micronutrients are as important as maj...

Vitamins Micronutrients are as important as major nutrients for the animal body. Vitamins are organic compounds required in minute amounts to assist metabolic processes and for

What do you mean by alzheimer''s disease, Q. What is Alzheimer's disease? ...

Q. What is Alzheimer's disease? The Alzheimer's disease is a degenerative disease of the central nervous system in which the patient has progressive dementia and alteration of

Brain region that receives conscious sensory information, Q. Which is the b...

Q. Which is the brain region that receives conscious sensory information? Which is the brain region that triggers the voluntary motor activity? In the brain conscious sensory i

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