Tuesday, March 14, 2017

Cardiovascular Surgery repair ASD

Atrial Septal Defect Closure (ASD)
Objective
   To open chest
   To close a defect (hole) in the atrial septum.
Position
   Left semilateral/supine.
Anesthesia
General, endotracheal.
Procedure
   1.  Catheterization: Cleaning and draping.
   2.  Skin incision with No. 4 BP handle with No. 20 blade.
   3.  Saw and cable for sternotomy.
   4.  Pericardiotomy: Stay suture 2/0 At. silk.
   5.  Loop the SVC and IVC.
   6.  Keep ready for venous tubing, aortic tubing and cardio­plegia tubing.
   7.  Aortic purse string 3.0 T3 single arm suture (2) cannulated.
   8.  IVC purse string and cannulation.
   9.  SVC purse string and cannulation.
10.  Aortic cannulation No. 11 knife for hole in the aorta. Insert cannula, silk tie. Connect the venous and arterial line in SVC and IVC.
11.  Cardioplegia stitch 4.0 T3 single arm, arterial line, scissors, snugger medium snap, cardioplegia cannula, silk tie.
12.  Scissors for opening the RA.
13.  Direct closure 4.0 T3 stitch or Dacron patch 4/0 Surgilene.
14.  RA closure 5/0 Prolene.
15.  Decannulation, Pacing wire.
16.  Drainage tube.
17.  Sponge and instruments count.
18.  Sternum closure—muscle and subcutaneous.
Instruments
   Cleaning tray
   Catheterization set
   Cardiac set
   Open heart vascular set
   Open heart special set
•           Open heart water seal.

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