Already have an account? Get multiple benefits of using own account!
Login in your account..!
Remember me
Don't have an account? Create your account in less than a minutes,
Forgot password? how can I recover my password now!
Enter right registered email to receive password!
Open Mitral Valvotomy : Technique: A median stemotomy is done; peri cardium opened and stay sutures taken. After heparinisation ascending aorta is cannulated and then SVC and IVC cannulae inserted. If the left atrium is small, tapes arc passed around SVC and NC cannulae for Lola1 cardio pulmonary bypass. Cardioplegia cannulae arc inserted into the ascending aorta and coronary sinus. The inter atrial groove is developed. Dissection to separated RA from LA gives better exposure to the mitral valve in case the left atrium is very small. By dissecting under SVC and IVC more of left atrium will be available for atriotomy. Left atrium could also be approached through right abiotorny and incising the septum (trans septa! approac11) or through the roof of left atrium between ascending aorta and superior vena cava (superior approach).
Aorta is clamped, left atrium opened and cardioplegia is given. Left atrium is widely opened and a Cooley atrial retractor or the self-retaining atrial retractor is applied. The valve is inspected for calcification and mobility. Stay sutures using 40' prolene are taken on the anterior and posterior cusp margins. By traction on the sutures the anterolateral and postern medial commissures are
identified. Stab incisions are made on the fused commissures close to the annulus and from there extended to the central orifice of the valve. The incision must be along the true commissure. Traction on the commissms using blunt hooks will help in identifying the chordae and papillary muscles. The fused chordae are separated by sharp dissection after identifying the ones going to
either of the leaflets. It may require incision into the papillary muscles and at times fenestration of the fused chordae, the essential principle is to get a mobile valve.
Decalcification of the leaflets will be required in some cases. The valve competence is kited by injecting saline into the LV. LRCt atrial incision is closed and complete de-airing of the left side of the heart is done. Aortic clamp is removed and de-airing through the aortic root needle is continued till heart ejects well and good blood pressure is achieved. Trans oesophageal echo is done to make sure the valvotomy is adequate and mitral regurgitation is less than mild. The assessnlent of MR should be when blood pressure is good. Open valvotomy is the procedure of choice when patient is in AF and left atrium has clots. The clots are removed; left atrium is washed and sucked thoroughly. Left atrial appendage is obliterated by tying it off from outside or by sutuiing from inside using prolene sutures. If the atrial fibrillation has been present for more than one year or left atrium is larger than 50mrns, it is better to combine a COX 111 (Maze) procedure to reduce the chances of post-operative atrial fibrillation.
Which of the following is TRUE about the properties of aqueous solutions? Select one: a. A pH change from 5.0 to 6.0 reflects an increase in the hydroxide ion concentration (
dog
Explain the term Light reflex - Neuronal pathways The neuronal pathway for light reflex can be afferent and efferent. In the afferent pathway, the pupillary fibres begin in the
What are the main conventional symbols and signs used in genetic family trees? In genetic family trees the male sex is usually shown by a square and the female by a circle. Cro
OESTROU S CYCLE - Also known as heat period. Common in rabbit, cat, dog, sheeps. In this period desire for copulation occur. Possibility of fertilization is 100%.
Nerves - Organisation of Nervous System Due to the pattern of distribution of neurons as described above, there are bundles of nerve fibers, called nerves, connecting the cent
Q. In which nephron portion does the regulation of alkalinity and acidity of the plasma occur? The regulation of the acid-basic equilibrium of the body is done by the kidneys a
Food Chain - Ecosystem In a food chain, the food energy is transformed from a given source through a series of species, each of which eats the one before itself in the chain.
Q. Symptoms of malabsorption syndrome? The most common symptoms are weakness, lassitude and marked weight loss. Steatorrhoea (excess fat in stools), anaemia and chronic ill h
General characters of aschelminthes
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!
whatsapp: +91-977-207-8620
Phone: +91-977-207-8620
Email: [email protected]
All rights reserved! Copyrights ©2019-2020 ExpertsMind IT Educational Pvt Ltd