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

Planeria, differnce between protonephridia and metanephridia

differnce between protonephridia and metanephridia

Types of ovarian cycles in mammals, Types of Ovarian Cycles in Mammals ...

Types of Ovarian Cycles in Mammals Mammals exhibit two types of ovarian cycles; Estrous Cycle, exhibited by non-primates such as rats, cats, dogs, pigs, and Menstr

Define the disorders due to the iodine deficiency, Define the Disorders due...

Define the Disorders due to the iodine deficiency? Mild goitre, i.e., a larger thyroid gland than normal. The mildest form of goitre ranges from those only detectable by to

What the enzymes do to reaction, What do enzymes do to a reaction? Indicate...

What do enzymes do to a reaction? Indicate all that are correct. a. Lower the activation energy b. Reverse the equilibrium c. Lower the equilibrium d. Increase the reac

Illustrate the metabolic processes of vitamin B, Illustrate metabolic proce...

Illustrate metabolic processes of vitamin B In the human and animal metabolism, they form a functional unit, since, as components of the various coenzymes, they are essential

Define the mechanism of evolution, A few statements about the mechanism of ...

A few statements about the mechanism of evolution are made. Mark the correct statements.   (i)  Evolution happens at the individual level as well as population level. (ii

Molluscus, what are the ecological importance of molluscus

what are the ecological importance of molluscus

What is the echocardiogram, What is the Echocardiogram ? When doubts pe...

What is the Echocardiogram ? When doubts persist whether a patient has CHD or not despite a thorough clinical exam and chest X-ray, ECG, and hyperoxia test, an echocardiogram s

What are the bone grafting issues, Bone grafting issues Planning of the...

Bone grafting issues Planning of the case is very critical. Any bone defect in the aesthetic zone should be evaluated prior to implant placement in order to obtain a prosthetic

#title.classification., merits and demerits system of classification by Lin...

merits and demerits system of classification by Linnaeus

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