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

What is leghemoglobin, The  nitrogenase  complex  is  extremely  sensitive ...

The  nitrogenase  complex  is  extremely  sensitive  to  inactivation  by  O2,  so  the enzyme  must be protected  from this reactive  substance.  During the root nodules of legumi

Why nutritional care is recognized as both science and art, Nutritional car...

Nutritional care can be recognized as both a science and art. Can you tell why? It is considered as a science because the raped  advances in scientific knowledge provides all h

Relationship between mind and brain, Q. Relationship between Mind and Brain...

Q. Relationship between Mind and Brain? In modern times, before the 20th century, the most popular interpretation of the mind-brain relationship was some version of dualism. It

Enzyme specificity, Enzyme Specificity Enzymes play a critical role wit...

Enzyme Specificity Enzymes play a critical role within biological systems through helping reactions to occur beneath the commonly mild conditions in that organisms live. Enzyme

Define about the eukaryotic cell, The eukaryotic cell The eukaryotic ce...

The eukaryotic cell The eukaryotic cell is a complex unit and contains many structural features not seen in in the simple prokaryotic cell. Fig below shows the details of vario

Cloning protocol, Sally Subcloner wants to clone a fragment into pUC19 (Map...

Sally Subcloner wants to clone a fragment into pUC19 (Map above - From New England Biolabs). Her fragment was a protein coding gene of 2.7 kb, and had Xho I sites on either end (a

Why poriferans and cnidarians do not have excretory systems, Poriferans and...

Poriferans and cnidarians do not have excretory systems. Do platyhelminthes have an excretory system? Platyhelminthes have a primitive excretory system made of flame cells (als

Types of development of animals, Types of Development of Animals Diffe...

Types of Development of Animals Different animals have evolved various methods of development. These methods can be broadly categorized into two categories (i) Direct devel

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