Off pump coronary artery bypass surgery opcab, Biology

Assignment Help:

Application :  Off Pump Coronary Artery Bypass Surgery (OPCAB)

CABG is done on epicai-dial vessels. Cardio pulmonary by pass is used only to get a still heart for accurate anastomosis. If there is a method of stabilizing a small area of the heart over the coronary artery with the rest or heart beating and maintaining reasonable haemodynamics, it is possible to do the operation off pump (OPCAB) or beating heart surgery. A few ingenious mechanical stabilizers achieve the local stabilization. The most commonly used one currently is "OCTOPUS", which has two blades with suckers. The two blades are placed on either side of the target artery and mild suction applied on the suckers. Another equipment "STARFISH" which resembles its name sake in the ocean, when applied to the apex of the heart helps in exposing any surface of the heart as required without much haemodynamic compromise.

When a partially occluded coronary or a 100 per cent blocked artery with good collaterals is opened, there will be considerable bleeding. To control that, suitably sized intra luminal shunt devices are available. They help to control bleeding, permit distal perfusion and do not interfere with the anastomosis. While the last few sutures are being applied, the shunt is removed arid anastomosis is completed. When a shunt is not used, a carbon dioxide blower will help in keeping the field free of blood.

To perform successful OPCAB good cooperation between the surgeon and the anesthesiologist is needed. Controlled hand ventilation is needed at crucial stages. Arterial pressure and ECC changes like ST-T changes are monitored when heart is rotated or Trans located into light pleura. Trans oesophagenl ECHO helps in rnonitoring region wall motion of left ventricle. Usually the operation is done through median sternotomy. Minimally invasive techniques or a left thoracotomy may be used in selected cases. Befo1.e grafting, hepasin is administered in doses of 1-3 mg/kg. Hypothernlin is be avoided. A pump is kept standby which could be assembled, primed and go1 ready in a matter of few minutes. It is important to make the anastomosis accurate. The advantage of OPCAB is that recovery is faster Patient can be extubated same day, transferred from ICU next day and discharged in 6-7 days time. This brings down the cost of hospitalization significantly.


Related Discussions:- Off pump coronary artery bypass surgery opcab

What are the reasons of food processing, What are the reasons of Food Proce...

What are the reasons of Food Processing? The reasons for food processing may vary, but the main objectives are to: Preserve the nutritive quality of food by preventing th

Pbpk modeling for improvement drug discovery , There are many characteristi...

There are many characteristics of the ideal drug candi-date. One of these is that its pharmacokinetics should meet its intended use. Many potentially useful drug can-didates, howev

Planting bacteria gardens, Planting bacteria gardens When the bacteria ...

Planting bacteria gardens When the bacteria gardens have cooled place them out on the table but do not increase the glass covers unless you are ready to plant them. Toothpicks

Foot as burrowing organ, Foot as Burrowing Organ The Scaphopoda that ...

Foot as Burrowing Organ The Scaphopoda that usually have burrowing habit, possess foot suitably modified for burrowing purpose. The conical and protrusible foot of Dentalium

Reduction in left ventricular, Q. Reduction in left ventricular? Vasodi...

Q. Reduction in left ventricular? Vasodilators improve stroke volume, and reduce degree of regurgitation. This results from decrease in systemic vascular resistance and leads t

Explain observations seen in thyphoid, Some observations seen in this fever...

Some observations seen in this fever are: 1.  Massive loss of  lean body mass or muscle due to tissue breakdown (250-500 g muscle tissue is lost/day) leading to excessive nitro

Principles of polymerase chain reaction , The PCR   (polymerase   chai...

The PCR   (polymerase   chain   reaction)   is   an   extremely   simple   as   immensely powerful methods.  It permits enormous  amplification  of any particular  sequence of DNA

Mention the name of the causal organism, a) Mention the name of the causal ...

a) Mention the name of the causal organism, symptoms and the mode of transmission of the disease Amoebiasis b) Mention the property that enables the explants to restore into a n

Mechanism of circulatory system, MECHANISM - 1 .      AURICULAR SYSTO...

MECHANISM - 1 .      AURICULAR SYSTOLE - First of all from complete body impure blood comes in R.A. by superior and inferior vena cava or pre and post cavals. Pure blo

Describe the typical composition of a virus, The human immune system has de...

The human immune system has developed diverse, coordinated methods of resisting and destroying viruses. a.  Describe the typical composition of a virus. Why are viruses not clas

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