CIRUGIA DE JATENE PDF

DE LA PARTE PEREZ, Lincoln. ANESTHESIA IN JATENE’S SURGERY, AN EXPERIENCE AT THE CARDIOLOGY CENTER OF “WILLIAM SOLER” HOSPITAL. Recursos Materiales y Humanos del Servicio de Cirugia cardiovascular 7. Organización para la corrección anatómica u Operación de Jatene siempre que. Cirugía de switch arterial: una historia de grandes esperanzas. mArsHALL L. JAcoBs1. Forty years ago, when Adib Jatene, in Sao Paulo, Bra- zil performed the.

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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 a large defect. This would have effectively reduced early mortality rates, particularly in cases with no concomitant shunts, corugia is unlikely to have reduced late mortality rates.

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 circumflex coronary artery may originate from the same coronary sinus as, rather than directly from, the right coronary artery, in which case they may still be excised on the same “button” and transplanted similarly to if they had a shared ostium, unless one or both have intramural communication with another coronary vessel. The aorta is then transplanted onto the pulmonary root, using either absorbable or permanent continuous suture. 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.

If the aortic 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.

The coronary arteries are carefully mapped out in order to avoid unexpected intra-operative complications in transferring them from the native aorta to the neo-aorta. This page was last edited on 4 Decemberat Views Read Edit View history.

Anestesia en la operación de Jatene, experiencia en el Cardiocentro del Hospital “William Soler”

Use of the arterial switch is historically preceded by two atrial switch methods: 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 Dde valve replacement production of septal defect in heart enlargement of existing septal defect Atrial septostomy Balloon septostomy creation of septal cirutia in heart Blalock—Hanlon procedure shunt from heart chamber to blood vessel atrium to pulmonary artery Fontan procedure left ventricle to aorta Rastelli jatenne 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.

An 8 day old right after the Jatene procedure. 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 Jarene procedure left ventricle to aorta Rastelli procedure right ventricle to pulmonary ciruyia 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.

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Although the atrial switch procedures dramatically reduced both early and late mortality rates, these statistics remained high, partly jatnee to the wait time required between birth and surgery pre-operative mortality: In the event of sepsis or delayed diagnosisa combination of pulmonary artery banding PAB and shunt construction may be used cirugua increase the left ventricular mass sufficiently to make an arterial switch possible later in infancy.

If the procedure is anticipated far enough in advance with prenatal diagnosis, for exampleand the individual’s blood type is known, a family member with a compatible blood type may donate some or all of the blood needed for transfusion during the use of a heart-lung cirugiia HLM. Eber was the first to recount a small series of successful arterial switch procedures, and the first large successful series was reported by Guatemalan surgeon Aldo R. However, in cases where the individual has been diagnosed but surgery must be delayed, maternal or even autologousin certain cases blood donation may be possible, as long as the mother has a compatible blood type.

The success of this procedure is largely dependent on the facilities available, the skill and experience of the surgeon, and the general health of the patient. Impedance cardiography Ballistocardiography Cardiotocography.

In most cases, though, the patient receives a donation from a blood bank. The great arteries are usually arranged using the LeCompte maneuverwith the cidugia cross clamp positioned to hold the pulmonary artery anterior to the ascending aorta; though with some congenital arrangements of the great dr, such as side-by-side, this is not possible and the arteries will be transplanted in the non-anatomic ‘anterior aorta’ arrangement.

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. InAmerican surgeons William Rashkind and William Miller transformed the palliation of d-TGA patients with the innovative Rashkind balloon atrial septostomywhich, unlike the thoracotomy required by a septectomy, is performed through the minimally invasive surgical technique of cardiac catheterization.

The HLM is turned off and the aortic and atrial cannula are removed, then an incision is made in the right atrium, through which the congenital or palliative atrial septal defect ASD is repaired; where a Rashkind balloon atrial septostomy 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.

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. When the patient is fully cooled, the ascending aorta is clamped as close as possible below the HLM cannula, and cryocardioplegia is achieved by jatehe cold blood to the heart via the ascending aorta below the jatenw clamp.

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By using this site, you agree to the Terms of Use and Cirigia Policy. A generous section of pericardium is harvestedthen disinfected and sterilized with a hatene solution df glutaraldehyde ; and the coronary and great artery anatomy are examined. Sometimes, one or more coronary ostia are located very close to the valvular opening and a small portion of the native aortic valve must be removed when the coronary artery is excised, which causes a generally mild, and usually well- toleratedneo-pulmonary valve regurgitation.

Coronary arteries are examined closely, and the ostia and proximal arterial course are identified, jaetne are any infundibular branches, if they exist.

Arterial switch operation

The patient will require a number of imaging procedures in order to determine the individual cirugoa of the great arteries and, most importantly, the coronary arteries.

Bythe arterial switch had become the procedure of choice, and remains the standard modern procedure for d-TGA repair.

Mustard first conceived of, and attempted, the anatomical repair arterial switch for d-TGA in the early s. In most cases, the coronary implantation sites will be at left and right anterior positions at the base of the neo-aorta; however, if the circumflex coronary artery branches from the right coronary arterythe circumflex coronary artery will be distorted if the pair are not implanted higher than normal on the neo-aorta, and in some cases they may need to be implanted above the aortic commissure, on the native aorta itself.

As with any procedure requiring general anaesthesia, arterial switch recipients will need to fast for several hours prior to the surgery to avoid the risk of aspiration of vomitus during the induction of anesthesia. The aortic clamp is temporarily removed while small sections of the neo-aorta are cut away to accommodate the coronary ostia, and a continuous absorbable suture is then used to anastomose each coronary “button” into the prepared space.

The world’s smallest infant to survive an arterial switch was Jerrick De Leon, born 13 weeks premature. Jatene procedure An 8 day old right after the Jatene procedure. The patient’s mother is normally unable to donate blood for the transfusion, as she will not be able to donate blood during pregnancy due to the needs of the fetus or for a few weeks after giving birth due to blood lossand the process of collecting a sufficient amount of blood may take several weeks to a few months.

Retrieved from ” https: The heart is accessed via median sternotomyand the patient is given heparin to prevent the blood from clotting. When the septal defects have been repaired and the atrial incision is closed, the previously removed cannula are replaced and the HLM is restarted.