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

Cleavage - metazoa, Cleavage - Metazoa The unicellular zygote begins c...

Cleavage - Metazoa The unicellular zygote begins cell division (cleavage). First, the single cell divides forming two cells, these redivide further to form four, then eight ce

Skin, what is the warmest and coldest parts of the boy

what is the warmest and coldest parts of the boy

Which does not contain a guanidinium group, Which of the following does NOT...

Which of the following does NOT contain a guanidinium group Select one: a. Urea b. arginine c. creatine d. guanidinium ion

Difference between micronutrients and macro, Q. What is the difference betw...

Q. What is the difference between micronutrients and macro? The classification criterion of nutrients into micronutrients and macro has no relation to the size of the molecul

Instances of human diseases caused by bacteria, Q What are instances of hum...

Q What are instances of human diseases caused by bacteria? Some human diseases caused by bacteria are tuberculosis, pertussis, diphtheria, gonorrhea, bacterial meningitis, bubo

Instrument examination and care, Instrument Examination and Care Cleani...

Instrument Examination and Care Cleaning instruments, provides a good opportunity to examine, replace or remove damaged instruments; lubricate items such as handpieces; and oth

Brackish water-marine water-types of water found on earth, Brackish Water ...

Brackish Water The content of dissolved salts in brackish water is higher than the fresh water and ranges between 0.5 to 35%. These waters of intermediate salinity range are d

What is composition, What is Composition? Blood consists of red blood c...

What is Composition? Blood consists of red blood cells, white blood cells, and platelets, suspended in a straw-colored liquid called plasma. If whole blood is centrifuged, abou

Arctic tundra, The northern most biome on our planet is the arctic tundra. ...

The northern most biome on our planet is the arctic tundra. It is a treeless wet circumpolar band between the polar ice caps and the forests to the south. The predominant plants

Define role of vitamin d in controlling gene expression, Define role of Vit...

Define role of Vitamin D in controlling gene expression? Vitamin D is a secosteroid that is metabolically activated and degraded through the actions of three cytochrome P450 hy

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