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

What is packaging, Q. What is packaging? What is packaging? Packaging...

Q. What is packaging? What is packaging? Packaging means a coordinated system of preparation of goods (in this case, foods) for shipment, distribution, storage and

How to calculate hydrogen ion concentration, Q. How to calculate Hydrogen I...

Q. How to calculate Hydrogen Ion Concentration? Ans. The hydrogen ion concentration has a significant role to play in growth of bacteria as every microorganism has a minim

Explain process of selection of taxonomic characters, Explain process of Se...

Explain process of Selection of taxonomic characters Selection of taxonomic characters Eventually classification systems may be based almost entirely on direct study of th

Benzene and ether non-polar or polar substances, Q. Are organic solvents li...

Q. Are organic solvents like benzene and ether non-polar or polar substances? the ethers and Benzene are molecules without electrically charged portions and thus they are non-p

Define transport proteins in plasma, Define Transport Proteins in Plasma? ...

Define Transport Proteins in Plasma? Transport proteins, embedded in lipid membranes, make easy the import of nutrients into cells or the release of toxic products into the sur

Illustrate fundamental sexual life cycles, Q. What are the three fundamenta...

Q. What are the three fundamental sexual life cycles studied in Biology? Which of them corresponds to metagenesis? Which of them is the human life cycle? Sexual reproduction ma

What are gametes, What are gametes? Gametes are cells specialized in s...

What are gametes? Gametes are cells specialized in sexual reproduction. They have half of the maximum number of chromosomes of the species and unite with another gamete giving

Bio-insecticides and bio-pesticides, A large number of plants are used for ...

A large number of plants are used for bio-pesticides and bio-fertilizers. Several plant species are used as insecticides against aphids and larvae of insect pests: for insects like

Subphylum opalinata, Subphylum Opalinata Body covered with longitudin...

Subphylum Opalinata Body covered with longitudinal rows of cilium like ,organelles but true ciliature absent. Parasitic; cytosome lacking; two to many nuclei of one type.

Nutrition affecting the growth of microorganism, Q. Can Nutrition affecting...

Q. Can Nutrition affecting the growth of microorganism? Ans. Food is food to humans and microbes - be it carbohydrates, proteins or fats. The nutritional requirements of b

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