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Aortic Valve replacement : The initial steps of the operation have been described earlier. Ascending aorta is cannulated. A single two-stage atrio-venous cannula is inserted through the right atrial appendage to IVC. Cardio plegia cannula is inserted into the ascending aorta and a retrograde cardioplegia cannula into the coronary sinus. A left sided vent is inserted through the right superior pulmonary vein. Aorta is clamped at moderate hypothennia (280C). If there is no aortic regurgitation, antegrade blood cardioplegia is given in the aortic root. Ice slush is applied in the pericardiurn to give additional myocardial protection. After heart is arrested, the rest of the cardioplegia is given retrograde. Hypertrophied ventricles need additional infusion of cardioplegia. If there is aortic regurgitation, the aorta is opened and direct antegrade cardioplegia is administered by cannulating the ostia with special hand held coronary arterial perfusion cannulae. A transverse aortotomy 15 mms above the origin of right coronary artery or an oblique one extending on to the non coronary sinus of aorta is made and stay sutures are taken. Lower aortotoiny flap is retracted and aortic valve is inspected. It is excised one cusp at a time leaving 2mm rim for suturing. When the valve is calcified, it has to be removed piece meal. A wet gauze piece is used to pack the inside of left ventricle to collect loose bits of calcium. Using a sharp knife, scissors or a bone rongeur calcium will have to be removed carefully taking precaution over the anterior mitral leaflet and the septum new the AV bundle (under the comrnissure between light and non coronary cusps). The gauze piece from LV is removed. Aorta and LV are washed with saline that is sucked out. Wet peanut gauze is used to clean the areas from where calcium has been removed. Valve orifice is measured and appropriate 'sized valve is chosen.
Digestion of carbohydrates Carbohydrate digestion in vertebrates and invertebrates is very similar. All the enzymes shown in Table are not required by all animals. The enzymes
An A=T mispairing leads to an A=C substitution. The other DNA helix will contain a(n) __ pair. a. A=C b. A=T c. G=C d. B=Q e. T=T Can you also explain it please so if I'm ask
Simple interrupted technique of Suturing The simple loop is the most commonly used technique in dentistry and is routinely used to adapt tension free, mobile surgical flaps.
Describe Lifetime Risk Estimation ? Traditional statistical and epidemiological methods of estimating long-term risks do not accurately reflect population burden of disease. Th
What is meningitis? Meningitis is the generic name given to inflammation of the meninges, membranes that cover the central nervous system. Meningitis can have various causes (i
What is Intracardiac Repair of Tetralogy of Fallot ? Technique : The essential steps are: (I) relief of right ventricular outflow obstruction, and (2) closure of ventricular
Maintenance Therapy A complete remission implies a clinical, haematological and bone marrow remission. For remission therapy drugs like, methotrexate cyclophospharnide and 6-
Waste generated is termed as "Biomedical Waste" which means a waste that may contain human pathogens of sufficient virulence and in sufficient concentrations that exposure to it by
How are gametes formed in the pteridophyte life cycle, by mitosis or meiosis? What is the type of meiosis that occurs in pteridophytes? In pteridophytes gametes are made by mit
How do placental mammals reproduce? Placental mammals reproduce sexually, they have internal fecundation and they are viviparous, i.e., their embryo creates within the mother's
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