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

Life, How life exist in earth?

How life exist in earth?

Show the structure of the adult fern, Q. What is the structure of the adult...

Q. What is the structure of the adult fern within which cells undergoing meiosis can be found? In these plants meiosis takes place within structures known as sorus (plural, sor

The activated methyl cycle, S-Adenosyl   methionine   serve  as  a  donor  ...

S-Adenosyl   methionine   serve  as  a  donor  of  methyl  sets  in  numerous biological  reactions instance for in the formation  of creatine phosphate and in the synthesis of nuc

Fats requirements for ulcerative colitis, Q. Fats requirements for ulcerati...

Q. Fats requirements for ulcerative colitis? Usual foods, which contain fats (invisible or inherent fat), are permitted but not fried foods, as they are not easily digested due

Explain some precautions for preparation of chloride buffers, Explain some ...

Explain some Precautions for Preparation of Chloride Buffers? 1. Glass electrodes should always be before and after measuring pH with a tissue paper. 2. The pipettes should

Glycogen synthesis, To synthesize glycogen two enzymes are needed: 1.  U...

To synthesize glycogen two enzymes are needed: 1.  UDP-glucose   pyrophosphorylase catalyzes the synthesis of UDP-glucose from UTP and glucose 1-phosphate:   The   py

Explain guar gum, Guar Gum Guar Gum is derived from seed of legume Cyam...

Guar Gum Guar Gum is derived from seed of legume Cyamopsis tetragonalobus resembling soyabean plant. Guar gum is composed of Galactomannan Galactose: mannose in the ratio 1:2.

How can nutrients are classified, According to their functions how can nutr...

According to their functions how can nutrients are classified? One possible and utile functional classification for nutrients is the one that divides them into energetic, struc

Describe the intensity of s2 in second heart, Describe the Intensity of S 2...

Describe the Intensity of S 2 in second heart ? Loud A 2 occurs in patients with hypertension, when aorta is closer to anterior chest wall owing to root dilatation or TGA or

Oxidative phosphorylation occurs in the inner membrane, In  eukaryotes,  th...

In  eukaryotes,  the electron  transport  and oxidative phosphorylation occurs in the inner membrane of mitochondria.  These processes re-oxidize the FADH 2 and NADH   which comes

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