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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.
FATS ( = True Fats, Triglycerides, Neutral Fats) They are esters of fatty acids and 3-carbon trihydric alcohol glycerol (= glycerine). T rue fat is also called trig
Equipment and Supplies: Nurses who are aware of location of equipment and supplies do give accurate delivery of patient care without delay and wastage of time and energy for
What are antioxidants? To put it simply, antioxidants are important naturally occurring nutrients, (vitamins, minerals) which help to protect body from certain types of cancers
Mechanics of Locomotion Among annelids, polychaetes, hence more primitive than the other two groups, show a more complex mode of locomotion. Necessarily, the locomotion in po
Q. Medical Therapy for aortic stenosis? Definitive therapy for aortic stenosis is surgical and medical therapy is only palliative. Infective endocarditis and rheumatic fever p
Q. How do kidneys participate in the blood volume control? How is the blood volume of the body related to the arterial pressure? The kidneys and the hormones that act upon them
Determine the function of human body system Human body has different systems to perform different functions. A system consists of organs to perform a particular set of function
I will send any further instructions to you. The ist part of the assessment (1-7) that evaluates the chart i have done but it needs to be looked at to see if content okay & gram
Contractile vacuole - Protozoans The contractile vacuoles may differ in complexity in various groups of protozoans. In amoebae the vacuoles are carried around in the cytoplasm
State the concespts of soil- pedology and edaphology In the last two centuries of scientific study, two concepts or approaches to the study of soil have evolved. One called p
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