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synthetic conduitsdacron polytetra fluro ethylene ptfe and polyglycolic acid grafts have extremely poor results and are not used any
inferior epigastric artery i this is a branch of external iliac artery supplying the abdominal wall it is raised as a free graft for cabg the
gastro epiploic artery ge gastro epiploic artery is a less popular arterial conduit now the midline chest incision is extended to the umbilicus
radial artery carpentier used radial aartc14y us a conduit for cabg in 197 1 he had 30 percent early occlusion of the graft and it was given up the
surgery for coronary artery disease stenotic coronary artery disease cad is caused by the thickening and narrowing of the coronary arteries
application off pump coronary artery bypass surgery opcabcabg is done on epicai-dial vessels cardio pulmonary by pass is used only to get a
off pump surgery in spite of great advancements in techniques of cardio pulmonary bypass it is still not physiological there can be various
total artificial heart jarvik seven was the first successful total artificial heart supporting the patient for 112 days the disadvantage is that
ventricular assist devices these come handy when iabp has failed or when prolonged circulatory support is needed now ieft ventricular lvad right
complications iabp can compromise blood flow to the leg at the time of insertion pumping or after removal of balloon it may also cause perforation
equipment basically it has an intra aortic balloon pump a balloon with a capacity of 40 ml is passed percutaneously through the femoral artery
contra indication it is absolutely contra indicated if their is more than trivial aortic regurgitation aortic aneurysm and severe aorto iliac
indication iabp is commonly used to supporting failing left ventricle after open-i1ca1-t surgery or in cardiogenic shock after myocardial
circulatory assist devices intra aortic balloon pump iaup was introduced by kantrowitz 19hx it is also known as counter pulsation or diastolic
haemo filtration ultra filtration during open heart surgery helps in removing excess fluid especially in renal failure patients patients are haemo
blood salvage and bloodless open-heart surgery at the time of cardio pulmonary bypass cardiomony suckers suck blood from the chambers or the heart
venting of the heart it is important that heart does not distend during cardio pulmonary bypass this is prevented by venting of the left side of
myocardial protection to a great extent the result of cardiac surgery depends on how well the myocardium is protected during cardio pulmonary
hypothermia hypothermia reduces the metabolic requirements of the body thereby reducing oxygen consumption it also preserves high-energy
open heart surgery when patient is connected lo cardio pulmonary bypass for an operative procedure it is considered to be open-heart operation in a
conduct of perfusion at the beginning of the bypass the pump output is usually kept at 24 litres per meter per minute on coming off bypass the
cannulation typically blood is drained by gravity through two cannulae inserted into the superior and inferior vena cavae during bypass if the
circuitry and priming the cardio pulmonary bypass circuit consists of oxygenator tubings cannulae cardiotomy reservoirs and cardioplegia attachments
heparinisation the patient should be fully heparinised before the start of cardio pulmonary bypass baseline activated clotting time is measured
heat exchangers this is an integral part of cardio pulmonary bypass and is designed to cool and warm the perfusate non-sterile water from ice