Already have an account? Get multiple benefits of using own account!
Login in your account..!
Remember me
Don't have an account? Create your account in less than a minutes,
Forgot password? how can I recover my password now!
Enter right registered email to receive password!
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.
Fertilization - Pre-Embryonic Development Ovulation generally takes place between 9th to 14th day after the end of last menstrual period. Fertilization of oocyte initiates dev
Q. Why is the concept of a single gene as ultimateunit of inheritance inadequate to provide a unitary explanation for protein synthesis, recombination and mutation? Answer:
Define Management and Nutritional Intervention using MNA - Undernutrition? A. For those categorized as well-nourished They need only be reminded of the importance
Q. What do you mean by Binomial system in binomial nomenclature? In the previous sections we have outlined the concepts of binomial nomenclature at International level and the
Explain Components of second heart sounds? The first component of S 2 is due to closure of aortic valve (A,). The second component is due to closure of pulmonary valve (P 2 ).
Define the Indicators of Nutrition? We will begin our study on this topic by first understanding what we mean by an indicator. An indicator is a "specific and measurable statis
Explain the Properties of hydrolysed soy proteins Partially hydrolysed soy proteins possess good foam stabilization properties and can be used as whipping agents in combination
What might be the value of the Everglade restoration plan? Everglades will protect endangered species, such as the Florida panther, and restore the water flow needed by many or
what is ontogeny recapitulates phyloeny
I need help with making a taxonomic key
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!
whatsapp: +91-977-207-8620
Phone: +91-977-207-8620
Email: [email protected]
All rights reserved! Copyrights ©2019-2020 ExpertsMind IT Educational Pvt Ltd