Techniques of closed mitral valvotomy, Biology

Assignment Help:

Techniques: operation is done under general endo tracheal anaesthesia. Patient is positioned with the left chest tilted up using a sand bag under left chest. Left antero lateral thorocotomy is done through 5" intercostals space. Pericardium is opened two cm in front of phrenic nerve stay sutures are taken. Pulmonary artery pressure is assessed by palpation. A vertical mattress suture is applied above the LV apex in an avascular area. Ventricular epicardium is incised and an opening is made in the LV. It is controlled by a snare by passing the threads through it. A purse string is applied a little anterior to the base of left atrial appendage. Before applying a clamp on she left atrial appendage, it is opened momentarily to let out blood and any clot present inside the appendage. Surgeon inserts the right index finger through the left atrial appendage incision and mitral valve is palpated and assessed for size of the orifice, calcification and degree of regurgitation. The actual valvotomy is done by a Tubb's dillator inserted in a closed position, through the previously made ventriculotomy. The Tubb's dilator handle a mechanism to open the two blades to the desired amount by a screw arrangement, Before insertion, the opening is adjusted to 2.25 cms by using a scale. The dilator is then inserted into LV with left hand and guided to LA through the tight mitral orifice by the right index finger in LA. By pressing the handle with the left hand the dilator opens to desired amount and the valve opens up. The dilutor blades are positioned against the valve cusps and not the commissures. Tile dilator is removed 2nd further gradual dilatations are done by adjusting the dilator lo 2.5, 2.75, 3, 3.25 01. 3:5 cms and repeating the dilatations until the valve opens up without producing significant regurgitation. The finger is removed. Left atrial appendage and L V apical incision are sutured. Usually the pulmonary artery becomes softer. Pericardium is closed with intermpted sutures and chest closed in layers after inserting a single chest drain. If there is significant pulmonary arterial hypertension, patient is ventilated for a few hou1-s or over night.

 


Related Discussions:- Techniques of closed mitral valvotomy

Effect on water bodies - dissolved oxygen (do), Effect on Water Bodies - Di...

Effect on Water Bodies - Dissolved Oxygen (DO) Most aquatic, organisms respire with oxygen dissolved in water. The quantity of dissolved oxygen in a unit volume of aerated wa

Determine the various neurobehavioural characteristics, Determine the vario...

Determine the various neurobehavioural characteristics Contemporary views of brain function tend to conceptualise localisation in interaction with a number of developmental and

Explain glycophorin, Since erythrocytes  red blood cells do not hold any su...

Since erythrocytes  red blood cells do not hold any sub cellular  organelles they are essentially  a membranous  sac for carrying  haemoglobin their plasma membrane  is a convenien

Illustrate working of mitochondria and chloroplasts, Q. How is the finding ...

Q. How is the finding of ribosomes inside mitochondria and chloroplasts explained? It is a strong hypothesis that chloroplasts and mitochondria were prokaryotes that associated

Respiration, explain the respiration that takes place in different organism...

explain the respiration that takes place in different organisms??

What is the implant site evaluation, Implant site evaluation 1. Ridge:...

Implant site evaluation 1. Ridge: Total buccolingual width of the ridge- the thickness of the soft tissue ( bucally +lingually)= Buccolingual width of the bone. There shou

What is ridgemapping, What is Ridgemapping The patient is given local ...

What is Ridgemapping The patient is given local anesthesia by infiltration to numb both the  facial (labial/buccal) and  lingual (palatal) mucosa. Using either a sharp straigh

What is risk scoring, What is Risk scoring ? Risk scoring is an instrum...

What is Risk scoring ? Risk scoring is an instrument to assess both the relative risk as well as the absolute risk of developing Cardio-vascular disease and mortality in an ind

Importance of the brain evolved from fishes to reptiles, Q. How has the imp...

Q. How has the importance of the brain evolved from fishes to reptiles? From the least to the most complex brain structure, it is evident that the brain, from fishes to beings

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