Explain arterial switch operation surgery, Biology

Assignment Help:

Explain Arterial Switch Operation Surgery?

This is the operation of choice for simple transposition of the great arteries as it ensures anatomical correction. The approach is through midline incision and median sternotomy. It is usually done with a high ascending aortic cannula and direct cannulation of SVC and IVC. Patient is cooled down to 18 to 25°C and pel-fusion flow reduced. There is no need for resorting to circulatory arrest.

Alternately, the operation could be done with single light atrial cannula and resorting to brief period of circulatory arrest. Heart is arrested by cold cardioplegic solution administered ante-grade through the aortic root. It could also be supplemented by retrograde cardioplegia through the coronary sinus.

The ductus is suture ligated and divided. Mobilisation of ascending aorta, inain and branch pulmonary arteries are done before cardio-pulmonary bypass. Large piece of pericardium is harvested and preserved for reconstruction of the pulmonary artery. The aorta is transacted above the coronary ostia. Pulmonary artery is transacted proximal to bifurcation. Coronary buttons are raised from their respective sinuses. They are re-implanted into the neo aorta, which was the previous pulmonary artery. A Le Compte manoeuvre is done by taking the pulmonary artery bifurcation anterior to the aorta. Two ends of the aorta are anastornosed - proximal pulmonary artery (neo aorta) to distal aortic segment.

PFO or ASD present is closed. At this stage the baby is rewarmed and aortic clamp released and heart allowed to beat. Right atrium is closed. Pulmonary artery is reconstiucted using two pericardial patches to fill up the sinuses from where coronary buttons were raised. Left atrial pressure monitoring line is inserted either through the appendage or through right superior Pulmonary vein.
Atrial and ventricular pacing wires are inserted.

Tran oesophageal echocardiogram will help in deciding adequacy of coronary circulation by assessing global and regional wall motion. The success of arterial switch operation depends on coronary arterial button transfer; which in turn varies according to the type of origin of coronary arteries in transposition of the great arteries.


Related Discussions:- Explain arterial switch operation surgery

Horse diseases-equine viral arteritis, Equine viral arteritis Equine v...

Equine viral arteritis Equine viral arteritis (EVA) is a highly contagious disease of equines and is caused by equine arteritis virus (EAV), a RNA virus belonging to the genus

Determine procedure for determination of protein content, Determine Procedu...

Determine Procedure for determination of protein content? Now carry out the procedure as enumerated herewith: 1. Preparation of standard albumin: A standard solution of 2 mg

Movement, Movement Movement is another characteristic of living things...

Movement Movement is another characteristic of living things. It does not always mean locomotion or movement from one place to another. In animals movement is quite obvious. W

Anti lipid drugs-peri operative problems, Anti Lipid Drugs :  The current ...

Anti Lipid Drugs :  The current thinking is that it is very important to keep lipid levels low. It helps in preventing atherosclerotic changes in venous grafts and the long-term p

Explain the bioavailability of folate, Explain the Bioavailability of Folat...

Explain the Bioavailability of Folate? Bioavailability of folate from naturally occurring food sources is variable and frequently incomplete, as mentioned earlier in the food

Nursing assessment of thalassemia patient, Nursing Assessment  If you ...

Nursing Assessment  If you observe a child of thalassemia major you can identify the following clinical  manifestations:  Anaemia with haemoglobin level of 3 to 8 gm per ce

Phases of water, Phases of Water The state of water can be changed from...

Phases of Water The state of water can be changed from gaseous to liquid and liquid to solid and vice versa by the addition or removal of heat energy. To convert one gram of li

Why is complementary base pairing important in dna structure, Why is comple...

Why is complementary base pairing important in DNA structure? Complementary base pairing is important because the hydrogen bonds between the bases hold the two strands of DNA

Do primary amines can act as bases, Primary amines can act as bases; they c...

Primary amines can act as bases; they can- Select one: a. Absorb a proton to become R-NH2+2 b. Release a proton to become R-NH2+ c. Absorb a proton to become R-NH3+

List various type of insulin, Q. List various type of insulin? Types of...

Q. List various type of insulin? Types of insulin: a) Rapid or Short acting b) Intermediate c) Combination d) Long acting

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