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.
Q. How is excretion done in amphibians? Adult amphibians have kidneys that filter blood. Nitrogen waste is excreted as urea so amphibians are ureotelic beings. The aquatic, lar
Methods to Overcome Incompatibility It has been possible to facilitate the germination of incompatible pollen by extracting pollen wall proteins from compatible pollen and su
is cnidaria having both interacellular & extracellular digestion?
Define Lipids - Tests for Presence of Exoenzymatic Activity? Lipids are also high molecular weight compounds. Enzyme lipases (esterases) cleaves the ester bond to form glycerol
What are the alleles of a gene? The Diploid individuals have paired chromosomes. For instance in humans there are 23 pairs of chromosomes totaling 46 chromosomes. Every pair co
what is the excretory organ of lizard
VITAMIN - E Also known as beauty vitamin / tocopherol / antisterlity vitamin . Antioxidant because it inhibits peroxide formation. It stops undesired oxidation. It
Q. Write the definition of counselling? The counselling process, involves various steps in a sequence as given below: 1. Rapport-Building 2. Locating the Problem 4. Pl
What is cytoskeleton? What are its main constituents in animal cells? Ans) Cytoskeleton is the cytoplasmic structure that handles the cell, keeps its shape and fixates and moves
A general agreerncnt anlong nll the human evolutionists who may have a very radical philosophical hackground and convictions is that man is the result of an extraordinary evolution
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