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Total Arterial Re-vascnlarisation : In total arterial re-vascularisalion (TAR) end of the right internal mammary artery (RIMA) or radial arlery (RA) is anastomosed to the side of left internal mammary artery (LIMA) as a T or Y graft. This is done before cardio pulmonary bypass. On bypass, LIMA s anastomosed to diagonal branch as side-to-side and to LAD as end-to-side graft. Then sequential anastomoses between RIMA and OM1, OM2 or OM3 are done as side-lo-side anastomosed and it ends in PDA or KCA as an end to side graft.
Some patients may need ionotropic support of dopamine, dobutamine or adrenaline. In spite of ionotropic support, if blood pressure is low and LA pressure is high, insertion of intra aortic ballon pump (IAUP) is indicated.
After patient is weaned off cardio pulmonary bypass, cannulae are removed and heparin is reversed with protamine sulphate. Chest is closed with two drains. Patients are taken off ventilator after a few hours or next morning and if no complications intervene they should be back in the ward next day. They are ready to go home in 9 to 10 days.
Diagnosis Lumbar puncture is done which shows cloudy CSF with increased pressure, the white cell count predominantly contains neutrophils. CSF proteins are increased but sug
Explain the Infarct Exclusive Technique? Infarct Exclusive Technique : Left ventriculotomy is done through the infarcted area. No attempt is made to close the ventricu
Research to Improve Health Care Delivery: Today, much of health care delivery system remains imitative and intuitive rather than innovative, creative or scientific in
Domestication - Wildlife It means that man has taken under his direct care the living beings which are useful to him. Through extensive breeding programmes, he has modified th
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POSSIBLE ERRORS IN DRUG ADMINISTRATION There can be various reasons for error in administering drugs: i) Poor communication of intention by the prescriber. ii) Failur
Determine what is dermal branchiae? External extensions of outer epidermis and peritoneum of the echinoderm body cavity. Both outer epidermis and inner peritoneum are lined wit
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Vitamin K (Menadione - Vitamin K3, oil soluble) Menadione is a yellow, lustrous, crystalline powder. It is easily soluble in benzene, soluble in fats and fatty oils. It is spa
Explain about Listeria monocytogenes infection Listeria monocytogenes is a gram-positive, motile, non-spore forming rod. It is widely distributed in nature and can be found on
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