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

Defense mechanisms of the body against harmful agents, Q. What are the two ...

Q. What are the two groups of defense mechanisms of the body against harmful agents or foreign? What is the difference between them? The body has many defense mechanisms agains

Organic molecules, Organic Molecules Some organic molecules in life...

Organic Molecules Some organic molecules in life are Carbohydrates and Lipids à C, H and O Proteins à C, H, O, N & sometimes S Nucleic acids à C, H, O, N & P

Explain the solubility in water of dietary fibre, Explain the Solubility in...

Explain the Solubility in Water of dietary fibre? Fibres that dissolve in hot water are soluble and those that do not, are insoluble. Several structural features affect solubil

Collection of cerebro-spinal fluid (csf), Collection of Cerebro-spinal Flui...

Collection of Cerebro-spinal Fluid (CSF) Examination of the CSF is one of the most useful laboratory procedures in neurological diagnosis. Four types of punctures ma

What is manifest squint, What is Manifest Squint (Heterotropia) Manifes...

What is Manifest Squint (Heterotropia) Manifest squint is a deviation of one eye from the normal position when the fusion reflex is present. The subcategories of manifest squin

Biosphere, The biosphere is composed of all living organism. This sphere in...

The biosphere is composed of all living organism. This sphere includes all the microorganism, plants and animals of earth. In fact biosphere involves interaction of living beings w

Preservatives-sulphur dioxide-bisulphites and sulphites, Normal 0 ...

Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4

Name the serogroups of meningitidis, Serogroups  Five major serogroups ...

Serogroups  Five major serogroups of N. meningitidis, A, B, C, Y and W-135, cause most human infection. Serogroup A is the leading cause of disease in the "meningitis belt" acr

Gel shift assay, Gel shift assay is a technique by which one can determine...

Gel shift assay is a technique by which one can determine whether a particular protein preparation contains factors which bind to the specific DNA fragment. At times when a radiol

Describe the various types of rna, Describe the various types of RNA? ...

Describe the various types of RNA? Types of RNA :  There are three different types of RNA, all formed by transcription from DNA: (1) Messenger RNA (mRNA) is a single unc

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