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

Explain about observation and classification of arthropoda, Explain about t...

Explain about the Observation and Classification of Arthropoda? Introduction In the previous unit you have examined the representatives of artliropoda.  In this unit, you wi

Name the endocytosis, Name the endocytosis?   A.  During endocytosis of...

Name the endocytosis?   A.  During endocytosis of GLUT4 transporters in fat cells, there is removal of GLUT4 transporters from plasma membranes.   B.  During endocytosis of

Determine instruments that are required for sterilizations, Determine the I...

Determine the Instruments that are Required For Sterilization? The word sterilization is derived from the Latin word 'Sterilic' meaning unable to produce offsprings. Sterilizat

Explain about peptic ulcer, Q. Explain about Peptic Ulcer? Peptic ulcer...

Q. Explain about Peptic Ulcer? Peptic ulcers are one of the more serious forms of gastrointestinal disorders of the gastrointestinal tract particularly the stomach. The prevale

PHYLUM MOLLUSCA, How we attempt a question of phylum mollusca?

How we attempt a question of phylum mollusca?

Optical rotation in organice compounds, how the optical rotaion occurs in g...

how the optical rotaion occurs in glucose and ribose?

How is excretion done in amphibians, Q. How is excretion done in amphibians...

Q. How is excretion done in amphibians? Adult amphibians have kidneys that filter blood. Nitrogen waste is excreted as urea so amphibians are ureotelic beings. The aquatic, lar

Hypocoagulation disorder and vitamin k deficiency, Which of the following p...

Which of the following patients likely faces the highest risk of an acquired hypocoagulation disorder and vitamin K deficiency? Answer A. A patient who is immunocompromised as a re

Define about right visual cortex, A question is flashed on a screen in the ...

A question is flashed on a screen in the left visual world of right-handed person Z. Person Z is a healthy individual with an normal nervous system.  Person Z has a patch over Z's

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