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

Define comprehensive dietary management regime of patient, Define Comprehen...

Define Comprehensive Dietary Management Regime of Patient? A comprehensive dietary management regime of the patient should be based on the patient profile as gathered pre and p

What are heterochromatin and euchromatin, Chromatin is uncondensed nuclear ...

Chromatin is uncondensed nuclear DNA, the typical DNA morphology in interphase (the phase of the cell cycle in which the cells is not separating itself). In this phase of the cell

Elongation: what is translocation, A Complex  of  elongation  factor  EF-G ...

A Complex  of  elongation  factor  EF-G  (also known as  translocase)  and  GTP example for  EF-G/GTP binds  to the  ribosome.  There are three concerted movements  now happen coll

Clinical use of brain imaging in disease management, Determine the Clinical...

Determine the Clinical use of brain imaging in disease management Clinical use of brain imaging in disease management has also grown, driven by broader availability of scannin

What is an immunotoxin, Immunotoxin is formed by conjugating or combining a...

Immunotoxin is formed by conjugating or combining an antibody with highly toxic agent.

Describe tr murmur and vsd murmur in details- heart diease, Describe TR Mur...

Describe TR Murmur and VSD murmur in details? TR Murmur :   Characteristic: Holosystolic murmur, loudest at left lower-sternal border and becomes louder with inspiration (Carv

Explain scope of food science and technology as a subject, Explain Scope of...

Explain Scope of Food Science and Technology as a Subject? Food science and technology has developed as a discipline to systematically organize and link various kinds of knowle

Define fraction in which calcium in plasma is present, Define Fraction in w...

Define Fraction in which Calcium in plasma is Present? Calcium in plasma is present in three major fractions: Ionized calcium Protein bound calcium Complexed c

Illustrate the structure of the central nervous system, Q. What is the stru...

Q. What is the structure of the central nervous system that regulates pulmonary respiration? The reaction is catalyzed by the enzyme carbonic anhydrase present in red blood cel

Spiral cleavage - metazoa, Spiral Cleavage - Metazoa In Spiral Cleavag...

Spiral Cleavage - Metazoa In Spiral Cleavage, however, the third and fourth cleavage planes are oblique to the polar axis and the resulting blastomeres do not lie on top of on

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