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

Important conditions for malabsorption syndrome, Q. Important conditions fo...

Q. Important conditions for malabsorption syndrome? Let us now discuss a few important conditions grouped collectively under the term of malabsorption syndrome. These are:

Cockroach - tracheal system, can you give brief diagram of the tracheal sys...

can you give brief diagram of the tracheal system of cockroach?

Explain about periimplant probing depth, Periimplant Probing Depth In c...

Periimplant Probing Depth In contrast to natural teeth, for which the average periodontal probing depth (PD) has been reported, the physiologic depth of the periimplant sulcus

Explain some guidelines to help in use drugs wisely, Explain some Guideline...

Explain some Guidelines to Help in Use Drugs Wisely? By now, you are aware that the interaction of foods and drugs is a complex problem. Researchers cannot always predict wheth

In what ways does over-grazing lead to soil erosion, In what ways does over...

In what ways does over-grazing lead to soil erosion? Over-grazing leads to erosion because (i) the animals delete all the vegetation, so exposing the soil to heavy rain, (ii) t

Difference between myosin and actin filaments, DIFFERENCE S BETWEEN MYOSIN...

DIFFERENCE S BETWEEN MYOSIN AND ACTIN FILAMENTS     Myosin filaments (primary filaments)   Actinfilament s (secondary filaments)

Explain the diarrhoeal management strategies, Explain the Diarrhoeal Manage...

Explain the Diarrhoeal Management Strategies? The diarrhoeal management strategies have had a major impact on less than 5 mortality rate. The distribution of ORS packets and ne

Chemical changes due to spoilage, Q.Explain Chemical changes due to spoilag...

Q.Explain Chemical changes due to spoilage A food item may have apparently looked safe and wholesome for you to eat, but the rumbling and grumbling in your stomach at night may

What about whale fins compared to fish fins, Q. Are the limbs modified into...

Q. Are the limbs modified into wings of bats and the wings of birds instance of evolutionary homology or analogy? What about whale fins compared to fish fins? Bird and Bat wing

Describe the nature of the enzymes, Describe the nature of the enzymes invo...

Describe the nature of the enzymes involved in the phosphorylation of glucose Phosphorylation of glucose: Glucose is converted to glucose-6-phosphate since phosphorylated inter

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