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

Crisis due to deforestation, Crisis due to Deforestation Due to conti...

Crisis due to Deforestation Due to continuing deforestation we are faced with a major ecological and socio-economic crisis. To reverse this trend of deforestation a National

Procedures for diagnosis - restriction enzyme analysis, R e striction...

R e striction enzyme analysis: The restriction endonuclease analysis of viral DNA fragments or DNA fingerprinting discovered in 1970s has revolutionized the study o

Function of dopamine in consciousness, Q. Function of Dopamine in conscious...

Q. Function of Dopamine in consciousness? An increase in dopamine activity produces an increase in wakefulness. Dopaminergic neurons in the ventral tegmental areas are constant

Assignment, Economic and ecological importance of protozoans

Economic and ecological importance of protozoans

What is the acrosome of the sperm cell, Q. What is the acrosome of the sper...

Q. What is the acrosome of the sperm cell? How is it formed? The acrosome is a structure that contains a great number of digestive enzymes it is formed by the union of Golgi ap

Measure to be taken in the event of tsunami, ·          If we are in danger...

·          If we are in dangerous areas, water, gas and electricity should be turned off quickly and we should move to a higher level of ground.                  ·          It s

What is neurotransmitter, What is neurotransmitter Consider Neuron B i...

What is neurotransmitter Consider Neuron B in the frog central nervous system whose plasma membrane has a previously unknown channel that is selectively conductive to a newly

Gastrulation, Gastrulation  Gastrulation is the process through whic...

Gastrulation  Gastrulation is the process through which the presumptive areas of organ specific rudimetns present on the surface of blastula move to their specific position

Phylum protozoa, diversification and economic importance

diversification and economic importance

Which are the plant tissues that cover the stem and leaves, Which are the p...

Which are the plant tissues that cover the stem and the leaves? The stem may be enclosed by epidermis (having stomata, cuticle and photosynthetic cells) as in monocots or, alte

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