CIRUGIA DE JATENE PDF

Muzragore This surgery may be used in combination katene other procedures for treatment of certain cases of double outlet right ventricle DORV in which the great arteries are dextro — transposed. The HLM is turned off and the aortic and atrial cannula are removed, then an incision is made in the right jatenne, through which the congenital or palliative atrial septal defect ASD is repaired; where a Rashkind balloon atrial jatne was used, the ASD should be able to be closed with sutures, but cases involving large congenital ASDs or Blalock-Hanlon atrial septectomya pericardial, xenograftor Dacron patch may be necessary. A generous section of pericardium is harvestedthen disinfected and sterilized with a weak solution of glutaraldehyde ; and the coronary and great artery anatomy are examined. However, in cases where the individual has been diagnosed but surgery must be delayed, maternal or even autologousin jxtene cases blood donation may be possible, as long as the mother has a compatible blood type.

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Muzragore This surgery may be used in combination katene other procedures for treatment of certain cases of double outlet right ventricle DORV in which the great arteries are dextro — transposed. The HLM is turned off and the aortic and atrial cannula are removed, then an incision is made in the right jatenne, through which the congenital or palliative atrial septal defect ASD is repaired; where a Rashkind balloon atrial jatne was used, the ASD should be able to be closed with sutures, but cases involving large congenital ASDs or Blalock-Hanlon atrial septectomya pericardial, xenograftor Dacron patch may be necessary.

A generous section of pericardium is harvestedthen disinfected and sterilized with a weak solution of glutaraldehyde ; and the coronary and great artery anatomy are examined. However, in cases where the individual has been diagnosed but surgery must be delayed, maternal or even autologousin jxtene cases blood donation may be possible, as long as the mother has a compatible blood type.

Use of the arterial switch is historically preceded by two atrial switch hatene The aorta is then transected at the marked spot, and the pulmonary artery is transected a few millimetres below the bifurcation. The previously harvested pericardium is then used to patch the coronary explantation sites, and to extend — and widen, if necessary — the neo-pulmonary root, which allows the pulmonary artery to be anastamosed without residual tension; the pulmonary artery is then transplanted to the neo-pulmonary root.

It was the first method of d-TGA repair to be attempted, but the last to be put into regular use because of technological limitations at the time of its conception. While the patient is cooling, the ductus arteriosus is ligated at both the aortic and pulmonary ostiathen transected at its center; the left pulmonary branchincluding the first branches in the hilum of the left lung, is separated from the supportive tissue; and the aorta is marked at the site it will be transected, which is just below the pulmonary bifurcationproximal to where the pulmonary artery will be transected.

From Wikipedia, the free encyclopedia. An 8 day old right after the Jatene procedure. The coronary arteries are carefully mapped out in order to avoid unexpected cirutia complications in transferring them from the native aorta to the neo-aorta.

The patient will continue to fast for up to a few days, and breastmilk or infant formula can then be gradually introduced via nasogastric tube NG tube ; the primary goal after a successful arterial switch, and before hospital discharge, is for the infant to gain back the weight they have lost and continue to gain weight at a normal or near-normal rate. Arterial switch operation — Wikipedia At the time of the operation on February 6,he weighed just over 1.

This page was last edited on 4 Decemberat Coronary arteries are examined closely, and the ostia and proximal arterial course are identified, as are any infundibular branches, if they exist.

Silk marking sutures may be placed in the pulmonary trunk at this time, to indicate the commissure of the aorta to the neo-aorta ; alternatively, this may be done later in the procedure. Bythe arterial switch had become the procedure of choice, and remains the standard modern procedure for d-TGA repair.

This procedure yielded early and late mortality rates comparable to the Senning procedure; however, a late morbidity rate was eventually discovered in relation to the use of synthetic graft material, which does not grow with the recipient and eventually causes obstruction. If the aortic commissure has not previously been marked, the excised coronary arteries will be used to determine the implantation position of the aorta.

The sternum and chest can usually be closed within a few days; however, the chest tubes, pacemaker, ventilator, and drugs may still be required after this time. In most cases, though, the patient receives a donation from a blood bank. Valve repair Valvulotomy Mitral valve repair Valvuloplasty aortic mitral Valve replacement Aortic valve repair Aortic valve replacement Ross procedure Percutaneous aortic valve replacement Mitral valve replacement production of septal defect in heart enlargement of existing septal defect Atrial septostomy Balloon septostomy creation of septal defect in heart Blalock—Hanlon procedure shunt from heart chamber to blood vessel atrium to pulmonary artery Fontan procedure left ventricle to aorta Rastelli procedure right ventricle to pulmonary artery Sano shunt compound procedures for transposition of great vessels Arterial switch operation Mustard procedure Senning procedure for univentricular defect Norwood procedure Kawashima procedure shunt from blood vessel to blood vessel systemic circulation to pulmonary artery shunt Blalock—Taussig shunt SVC to the right PA Glenn procedure.

InAmerican surgeons Alfred Blalock and C. By using this site, you agree to the Terms of Use and Privacy Policy. Jatene procedure An 8 day old right after the Jatene procedure. Impedance cardiography Ballistocardiography Cardiotocography.

This would have effectively reduced early mortality rates, particularly in cases with no concomitant shunts, but is unlikely to have reduced late mortality rates. The aorta is then transplanted onto jateje pulmonary jatebe, using either absorbable or permanent continuous suture. The patient is fitted with chest tubestemporary pacemaker leads, and ventilated before ed from the HLM is cjrugia. Pericardium Pericardiocentesis Pericardial window Pericardiectomy Myocardium Crugia Dor procedure Septal myectomy Ventricular reduction Alcohol septal ablation Conduction system Maze procedure Cox maze and minimaze Catheter ablation Cryoablation Radiofrequency ablation Pacemaker insertion Left atrial appendage occlusion Cardiotomy Heart transplantation.

The ductus arteriosus and right pulmonary branchup to and including the first branches in the hilum of the right lungare separated from the surrounding supportive tissue to allow mobility of the vessels. Egyptian cardiac surgeon Magdi Yacoub was subsequently successful in treating Re with intact septum when preceded by pulmonary artery banding and systemic-to-pulmonary shunt palliation.

As the patient is anesthetized, they may receive the following drugswhich continue as necessary throughout the procedure:.

Rollins Hanlon introduced the Blalock-Hanlon atrial septectomywhich was then routinely used to palliate patients. If the dr commissure has not yet been marked, it may be done at this point, using the same method as would be used prior to bypass; however, there is a third opportunity for this still later in the procedure. Infundibular branches are sometimes unable to be spared, but this is a very rare occurrence. Arterial switch operation As with any procedure requiring general anaesthesia, arterial switch recipients will need to fast for several hours prior to the surgery to avoid the jstene of aspiration of vomitus during the induction of anesthesia.

Heart valves and septa Valve repair Valvulotomy Mitral valve repair Valvuloplasty aortic mitral Valve replacement Aortic valve repair Aortic valve replacement Ross procedure Percutaneous aortic valve replacement Mitral valve replacement production of septal defect in heart enlargement of existing septal defect Atrial septostomy Balloon septostomy creation of septal defect in heart Blalock—Hanlon procedure shunt from heart chamber to blood vessel atrium to pulmonary artery Fontan procedure left ventricle to aorta Rastelli procedure right ventricle to pulmonary artery Sano shunt compound procedures for transposition of great vessels Arterial switch operation Mustard procedure Senning procedure for univentricular defect Norwood procedure Kawashima procedure shunt from blood vessel to blood vessel systemic circulation to pulmonary artery shunt Blalock—Taussig shunt SVC to the right PA Glenn procedure.

If there is a VSD which has not yet been repaired, this is performed via the atrial incision and tricuspid valveusing sutures for a small defect or a patch for ccirugia large defect. The patient will require a number of imaging procedures in order to determine the individual anatomy of the great arteries and, most importantly, the coronary arteries.

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Zululabar Arterial switch operation — Wikipedia The patient will continue to fast cirygia up to a few days, and breastmilk or infant formula can then be gradually introduced via nasogastric tube NG tube ; the primary goal after a successful arterial switch, and before hospital discharge, is for the infant to gain back the weight they have lost and continue to gain weight at a normal or near-normal rate. A generous section of pericardium is harvestedthen disinfected and sterilized with a weak solution of glutaraldehyde ; and the coronary and great artery anatomy are examined. If a ventricular septal defect VSD is present, it may be repaired, at this point via either the aortic or pulmonary valve ; it may alternatively be repaired later in the procedure. Eber was the first to recount a small series of successful arterial switch procedures, and the first large cirjgia series was reported by Guatemalan surgeon Aldo R.

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CIRUGIA DE JATENE PDF

Uma vez estabelecido o diagnstico, o tratamento de emergncia consiste em estabelecer uma mistura adequada, que e obtida atravs da triosseptostomia por cateter-balo Tcnica de Rashkind. O recem-nato em boas condies clnicas, isto e, compensado da cianose metablica e hipxia, devera ser submetido a cirurgia de Jatene, isto e, correo anatmica a nvel arterial. Outras tcnicas de correo podem ser realizadas a nvel atrial, desde que as condies anatmicas no permitam a correo a nvel arterial. Por ser um procedimento cirrgico mais complexo do que as correes atriais e, tambm, pela necessidade de interveno no perodo neonatal, a mortalidade hospitalar com a tcnica de Jatene foi relativamente alta no incio da experincia 1,3.

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