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

How are amino acids brought to the cellular site, How are amino acids broug...

How are amino acids brought to the cellular site where translation takes place? What is an anticodon? Amino acids are brought to ribosomes by RNA molecules called as transfer R

Gonads and ovary - reproduction, Normal 0 false false false...

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

What is the valve that separates the aorta from the heart, What is the valv...

What is the valve that separates the aorta from the heart? What is the importance of that valve? The valve among the left ventricle and the aorta is the aortic valve. The aorti

Explain the periodontal consideration, Explain the Periodontal consideratio...

Explain the Periodontal consideration Periodontal consideration would include: Hard Calculus Build up:   Any index assessing the amount of calculus build up can be used .

Explain congenital heart disease (chd), Explain Congenital Heart Disease (C...

Explain Congenital Heart Disease (CHD)? Congenital heart disease is an abnormality at birth in cardiac circulatory structure or function. Optimal management of CHD aims not mer

What do you know by hemodynamic responses, Q. What do you know by Hemodynam...

Q. What do you know by Hemodynamic Responses? Reduced exercise capacity roughly reflects impaired LV function, and may contribute its prognostic value to this association. Comp

DNA, What is replication fork??

What is replication fork??

What are the plant hormones, What are the plant hormones? The Plant hor...

What are the plant hormones? The Plant hormones also called as phytohormones, are the substances that control the embryonic development and the growth of the adult plant.

Explain saturated fatty acids, Saturated fatty  acids General formula o...

Saturated fatty  acids General formula of saturated fatty acids  is CH3  (CHI), COOH. It has a polar end with a free XOOH group and a non-polar end with a hydrocarbon chain, as

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