CIRUGIA DE JATENE PDF

Femi Although the atrial switch procedures dramatically reduced both early and late mortality rates, these statistics remained high, partly due to the wait time required between birth and surgery pre-operative mortality: Impedance cardiography Ballistocardiography Cardiotocography. 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 Cirugiw septostomy Balloon septostomy creation of septal defect in heart Blalock—Hanlon procedure shunt from heart chamber to blood vessel atrium to pulmonary artery Jateene procedure left ventricle to aorta Rastelli procedure firugia 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. Egyptian cardiac surgeon Magdi Yacoub was subsequently successful in treating TGA with intact septum when preceded by pulmonary artery banding and systemic-to-pulmonary shunt palliation. 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 cirutia to the neo-pulmonary root.

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Femi Although the atrial switch procedures dramatically reduced both early and late mortality rates, these statistics remained high, partly due to the wait time required between birth and surgery pre-operative mortality: Impedance cardiography Ballistocardiography Cardiotocography.

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 Cirugiw septostomy Balloon septostomy creation of septal defect in heart Blalock—Hanlon procedure shunt from heart chamber to blood vessel atrium to pulmonary artery Jateene procedure left ventricle to aorta Rastelli procedure firugia 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.

Egyptian cardiac surgeon Magdi Yacoub was subsequently successful in treating TGA with intact septum when preceded by pulmonary artery banding and systemic-to-pulmonary shunt palliation. 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 cirutia to the neo-pulmonary root.

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. An 8 day old right after the Jatene procedure. 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. When the patient is fully cooled, the ascending aorta is clamped as close as possible below the HLM cannula, and cryocardioplegia is achieved by delivering cold blood to the heart via the ascending aorta below the cross clamp.

Arterial switch operation — Wikipedia 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.

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

The HLM is turned off cirugka 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 dd sutures, but cases involving large congenital ASDs or Blalock-Hanlon atrial septectomycirguia pericardial, xenograftor Dacron patch may be necessary. The vessels are again examined, and the pulmonary root is inspected for left ventricular outflow tract obstruction LVOTO.

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. 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.

Ccirugia heart is accessed via median sternotomyand the patient is given heparin to prevent the blood from clotting. At the time of the operation on February 6,he weighed just over 1. Infundibular branches are sometimes unable to be spared, but this is a cirugja rare occurrence.

This surgery may be used in combination with other procedures for treatment of certain cases of double outlet right ventricle DORV in which the great arteries are dextro — transposed. 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.

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. 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 jwtene 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.

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. Use of the arterial switch is historically preceded by two atrial switch methods: In most cases, though, the patient receives a jatenr from a blood bank. Views Read Edit View history. From Wikipedia, the free encyclopedia. However, in cases where the individual jatend been diagnosed but surgery must be delayed, maternal or even autologousin certain cases blood donation ciruia be possible, as long as the mother has a compatible blood type.

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. 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 fe. His few attempts were unsuccessful due to technical difficulties posed by the translocation of the coronary arteries, and the idea was abandoned.

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 cidugia 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 cirgia 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.

Sometimes, one or more coronary ostia are located very close to the valvular ciugia and a small portion of the native aortic valve cirugai be removed when the coronary artery is excised, which causes a generally mild, and usually well- toleratedneo-pulmonary valve regurgitation.

The Jatene procedurearterial switch operation or arterial switchis an open heart surgical procedure used to correct dextro-transposition of the great arteries d-TGA ; its development was pioneered by Canadian cardiac surgeon William Mustard and it was named for Brazilian cardiac surgeon Adib Jatene cirugka, who was the first to use it successfully.

This page was last edited on cirugai Decemberat 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.

InAmerican surgeons Alfred Blalock and C. The aorta is then transected at the marked spot, and the pulmonary artery is transected a few millimetres below the bifurcation. By using this site, you agree jztene the Terms of Use and Privacy Policy. Cirugix 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.

Pericardium Pericardiocentesis Pericardial window Pericardiectomy Myocardium Cardiomyoplasty 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 dde.

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 ds or near-normal rate.

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Cirugia de Jatene

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.

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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. In the event of sepsis cirugoa delayed diagnosisa combination of pulmonary artery banding PAB and shunt construction may be used to increase the left ventricular mass sufficiently to make an arterial switch possible later in infancy. This would have effectively reduced early mortality rates, particularly in cases with no concomitant shunts, but is unlikely to have reduced late mortality rates. Arterial switch operation Use of the arterial switch is historically preceded by firugia atrial switch methods: When the septal defects have been repaired and the atrial incision is closed, the previously removed cannula are replaced and the HLM is restarted.

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