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

How is retaining wall works, How is retaining wall works? A retaining w...

How is retaining wall works? A retaining wall together with the backfill the wall retains and the soil that supports the wall is a highly indeterminate system. The magnitudes o

Define disadvantages of direct microscopic count, Define Disadvantages of D...

Define Disadvantages of Direct Microscopic Count? 1. Small cells are difficult to see under the microscope and may be missed. 2. It gives total count, i.e., both live and de

Selection according to endemic species richness, An alternative approach ha...

An alternative approach has been to identify areas with the highest number of endemics or species with a restricted geographical range. Assessments of this nature have been very of

Packaging of meat products, P a ck a g i n g of Meat Products Me...

P a ck a g i n g of Meat Products Meat needs to be packaged to prevent contamination, color deterioration, loss of moisture, odor pickup, oxidative rancidity etc and pro

Define the recommended dietary allowance for vitamin b12, Define the Recomm...

Define the Recommended Dietary Allowance for Vitamin B 12 (RDA)? Vitamin B 12 deficiency is common in true vegans who can be treated with small doses since the daily requirem

Molecules that make possible active transport, Which are the molecules that...

Which are the molecules that make possible active transport through membranes? Ans) Active transport is made by particular membrane proteins. These proteins are known as "pumps"

Embryogenesis, Phenomenon of embryogenesis is not confined to the reproduct...

Phenomenon of embryogenesis is not confined to the reproductive system

Gastrulation in amphibians, Gastrulation in Amphibians Amphibians com...

Gastrulation in Amphibians Amphibians comprise a large and moderately telolecithal egg. Cleavage is holoblastic and unequal generating a spherical blastula along with a reduc

Budding- asexual reproduction, Normal 0 false false false ...

Normal 0 false false false EN-IN X-NONE X-NONE MicrosoftInternetExplorer4

What are multiple alleles, What are multiple alleles? Is there dominance in...

What are multiple alleles? Is there dominance in multiple alleles? Multiple alleles is the phenomenon in which the similar gene has more than two dissimilar alleles (in normal

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