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

Pseudopodia – protozoans, Pseudopodia – Protozoans Pseudopodia are flo...

Pseudopodia – Protozoans Pseudopodia are flowing cytoplasmic protrusions of the cell causing amoeboid movement. In protozoans pseudopodia exist in several forms. The most fami

Electron acceptor, Electron acceptor is a molecule which forms the part of...

Electron acceptor is a molecule which forms the part of the electron transport system which transfers electrons ejected by chlorophyll during the process of photosynthesis. Part o

Breathing and airway - initiation of cpr, Airway: Place the patient  s...

Airway: Place the patient  supine on a firm  surface with his  head at level  or  slightly lower than the level of heart. Immediately, clear the  airway and start  rescue brea

Explain the soft diet, Explain the soft diet The soft diet provides so...

Explain the soft diet The soft diet provides soft whole food that is lightly seasoned and moderately low in fibre. The foods have a soft  texture and are easy  to digest. Smal

Explain the community ecology of disease, Explain the Community ecology of ...

Explain the Community ecology of disease? Ebola, hantavirus, bubonic plague, Lyme disease, West Nile virus, rinderpest, and canine distemper virus are all instances of diseases

Explain foaming properties of proteins, Explain Foaming Properties of prote...

Explain Foaming Properties of proteins To understand the foaming properties of proteins, we need to know some basic aspects of foam foods. Foam foods are usually colloidal disp

Coral reefs, Coral reefs form in clear warm tropical seas and are particula...

Coral reefs form in clear warm tropical seas and are particularly well developed in the South Pacific. They are formed by accumulation in calcarious skeletons of tiny colonial anim

What is the meaning of reitan''s program, What is the meaning of Reitan's p...

What is the meaning of Reitan's program Reitan's program can be conceptualised as an effort to demonstrate the usefulness nad accuracy of Halstead's tests and related procedure

Define reagents for seliwanoff test, Define Reagents for seliwanoff's tes...

Define Reagents for seliwanoff's test? - Sugar solutions of glucose, fructose, galactose, lactose, maltose, sucrose and starch - Resorcinol in dilute hydrochloric acid (1:

Ruminal tympany (bloat), R uminal tympany (Bloat) It is the over-diste...

R uminal tympany (Bloat) It is the over-distension of the rumen with gases which may be either frothy or free gas. The disease is characterized by change in silhouette of the

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