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

Of which substance are microtubules made, Of which substance are microtubul...

Of which substance are microtubules made? In which structures and cellular processes do microtubules participate? Microtubules are made of consecutive dimers of the protein tub

Haemodynamic study of constrictive pericarditis, Q. Haemodynamic Study of c...

Q. Haemodynamic Study of constrictive pericarditis? Simultaneous right and left heart studies are useful. Due to exaggerated waves in atria, W-shaped atrial pressure tracing wi

Elaborate the internal vascular circulation of an eye, Elaborate the intern...

Elaborate the internal vascular circulation of an eye. Retinal vessels are derived from central retinal artery and are distributed within the inner two-third of retina. Outer o

Physical properties of protoplasm, P HYSICA L PROPERTIES OF PROTOPLASM - ...

P HYSICA L PROPERTIES OF PROTOPLASM - 1 .       Phase reversal - Due to difference in temperature outer part is gel and inner part of sol 2.       Tyndall effect - Be

Isonzerization of glucose-6-phosphate, Isonzerization of glucose-6-phosphat...

Isonzerization of glucose-6-phosphate Isonzerization  of  glucose-6-phosphate :  This step  is  catalyzed  by phosphoglucoisomerase to  form  fructose-6-phosphate.

Explain procedure of aortic valvuloplasty, Q. Explain procedure of Aortic V...

Q. Explain procedure of Aortic Valvuloplasty? BAV is usually performed by the retrograde transarterial approach. Often another catheter is placed in the LV through transseptal

What is fermentation, What is fermentation? Name any two organic compounds ...

What is fermentation? Name any two organic compounds formed in this process

Illustrate the term cilia, Illustrate the term Cilia? A cellular hairli...

Illustrate the term Cilia? A cellular hairlike locomotory structure which comprises an extension of the plasma membrane surrounding a 9+2 organization of microtubules. Unlike f

What substance is prepared from species of red algae, Name that gelatin-lik...

Name that gelatin-like substance which is prepared from different species of red algae growing in Asiatic waters. Prepared product appears in the form of cakes, coarse granules and

Endocrine, Adrenal causes of hypertension are: 1) Excess of aldosterone ...

Adrenal causes of hypertension are: 1) Excess of aldosterone production in primary aldosteronism. The diagnosis may be suspected when persistent hypokalemia is detected. Most of

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