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

Effect on microbial growth and activity, Effect on Microbial Growth and Act...

Effect on Microbial Growth and Activity Bacteria require higher aw for growth than fungi. Gram-negative bacteria have higher requirements than gram positives. Most spoilage ba

Respiration in adult amphibians and fishes, Q. Do amphibians have direct de...

Q. Do amphibians have direct development? In amphibians the embryonic development is indirect there is a larval stage. Q. How different are the respiration in adult amphibi

Reproduction, The fusion of two individuals with each acting as a gamete is...

The fusion of two individuals with each acting as a gamete is known as

Explain scope of food science and technology as a subject, Explain Scope of...

Explain Scope of Food Science and Technology as a Subject? Food science and technology has developed as a discipline to systematically organize and link various kinds of knowle

How you show that yeast acts on sugar, Normal 0 false false ...

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

Electroconvulsive therapy, ELECTROCONVULSIVE THERAPY: 1)  ConceptlMean...

ELECTROCONVULSIVE THERAPY: 1)  ConceptlMeaning of  Electroconvulsive Therapy  (ECT) Electroconvulsive Therapy (ECT) is a painless form of  electric therapy. It is called as ph

Tricuspid excision-types of surgery, Tricuspid Excision :  For tricus...

Tricuspid Excision :  For tricuspid valve endocarditis with vegetations in drug users, valve excision is done by removing three cusps and chordae and papillary muscles. Later

Explain requirements and recommended dietary intake, Explain Requirements a...

Explain Requirements and Recommended Dietary Intake? A very small daily intake of vitamin C (10-15 mg/day for an adult) is required to avoid deficiency and stave off scurvy. Ho

TAKHTAJANS classification, comparison between takhtajans and natural classi...

comparison between takhtajans and natural classification

Explain sound production - ethological approach in taxonomy, Explain Sound ...

Explain Sound production - Ethological Approach in Taxonomy The most used, ethological feature in identification is the sound produced by various species of animals. This is

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