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 information required for management of emergencies, Define Informati...

Define Information Required for Management of Emergencies? Management or intervention needs accurate information about the actual situation and includes many non-nutritional co

Quality control of feedstuffs, Quality control of feedstuffs Quality co...

Quality control of feedstuffs Quality control is essential at all stages in the production of compound feed so that animals could get wholesome balanced and nutritious feed. Th

Treatment of diarrhea, Treatment of diarrhea Loperamide (Imodium, and o...

Treatment of diarrhea Loperamide (Imodium, and others), an over-the-counter synthetic opioid (4-mg loading dose, then 2 mg orally after each loose stool to a maximum of 16 mg/d

Explain use of repellents, Use of repellents Avoidance and early remova...

Use of repellents Avoidance and early removal of ticks are the first steps in prevention of Lyme disease. In highly endemic areas, when an engorged Ixodes scapularis tick is at

What is st elevation, Q. What is ST Elevation? Although a stable LV ane...

Q. What is ST Elevation? Although a stable LV aneurysm may manifest ST-segment elevation in the precordial leads at rest. Some subjects with normal hearts show a degree of elev

Treatment of infective endocarditis, Two major objectives must be achieved ...

Two major objectives must be achieved to treat IE effectively. The infecting  micro-organism in the vegetation must be eradicated. Also, invasive, destructive intracardiac and foca

Nuclear transfer method for gene transfer, Nuclear transfer method: Nucle...

Nuclear transfer method: Nuclear transfer will extend the range of species in which gene targeting will be possible and thereby provide better models to test treatments for human

Exchange list vs. food composition tables for menu planning, Define Exchang...

Define Exchange list vs. Food composition tables for menu planning? A dietician is frequently expected to make quick, yet reasonably accurate estimation of the nutritive value

Explain phylogenetic or cladistic classification, Phylogenetic or Cladistic...

Phylogenetic or Cladistic Classification Phylogeny plays a great role in classification. It is the  appropriate theoretical background for taxonomy and is quite essential in exp

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