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

How to increased co2 levels in the atmosphere, Increased CO 2 levels in th...

Increased CO 2 levels in the atmosphere are correlated with rising global temperatures, leading many scientists to believe that the first phenomenon has caused the second. What wo

Body musculature - locomotion, Body Musculature - Locomotion The layou...

Body Musculature - Locomotion The layout of the muscle layers surrounding the coelom is necessarily the same in all the major classes of Annelida. The body wall has a layer of

Receptors - eye, EYE HISTOR Y - Steva n described it first. S...

EYE HISTOR Y - Steva n described it first. Study of eye is ophthalmology. Instrument used to examine interior of eye is  ophthalmoscop e . SHAP E - More o

Joints, JOINTS - The structural arrangement of tissues which connect 2 ...

JOINTS - The structural arrangement of tissues which connect 2 or more bones together at their place of meeting is called a joint. Study of joint is arthrology. Joint make the

Determine the sarcomere of a skeletal muscle, In the sarcomere of a skeleta...

In the sarcomere of a skeletal muscle, there are A. myosin molecules in the I band. B. both tropomyosin and myosin molecules in the region of the A band that is not in the H

Organic Evolution, I am studying the evolution of a giraffe. How do I find ...

I am studying the evolution of a giraffe. How do I find more information?

Main parts into which a neuron can be divided, Q. What are the three main p...

Q. What are the three main parts into which a neuron can be divided? What are their respective functions? The three mains parts into which a neuron can be didactically divided

What are the tissues that form the skin in vertebrates, Q. What are the tis...

Q. What are the tissues that form the skin in vertebrates? The skin of vertebrates is made of epidermis is an external layer of epithelial tissue and dermis a layer of connecti

Define protein requirement for cancer patients, Define Protein Requirement ...

Define Protein Requirement for Cancer Patients? Both the metabolic stress of cancer, as well as, chemotherapy results in increased tissue catabolism. Hypoalbuminemia and anaemi

Trophic level - ecosystem, Trophic Level - Ecosystem In an ecosystem, ...

Trophic Level - Ecosystem In an ecosystem, the various biotic components are related to each other and form food chains. If we group all the organisms in a food chain accordin

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