Clinical Case February 21 2024 Isis Daniela Rojas
Clinical Case February 21 2024 Isis Daniela Rojas
Clinical Case February 21 2024 Isis Daniela Rojas
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• Surgical: Transverse colon pilopus resection content/uploads/2019/07/shutterstock_304668368.jpg
DIAGNOSTIC EXAMS
•Diagnostic Images:
oTransesophageal echocardiogram (TEE):
Severe dilation of the left ventricle with reserved
systolic function, LVEF 58%, severe left atrial
dilation, right ventricle of normal size and
systolic function, aortic valve sclerosis
generating severe insufficiency, without
stenosis, mild mitral insufficiency
oCoronary arteriography: left coronary ostium
and trunk without lesions, patent anterior
descending artery, dominant artery without https://www.google.com/url?sa=i&url=https%3A%2F%2Fcardiologoenguadalajarachavoll
lesions
a.com%
Normal Clotting
blood count times in
Does not present
without cell
electrolyte disorders
series normal
disorders parameters
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SURGICAL INSTRUMENTATION PROCESS
Check list:
• Instrumental
SURGICAL INSTRUMENTATION PROCESS
Check list:
Equipment: Defibrillator, reciprocating saw, electro console,
Internal defibrillator paddles, sky lamps, tables.
SURGICAL INSTRUMENTATION PROCESS
Check list:
Check list:
Basic medical devices :Surgical instrumentation cart and
clothing package Specialized medical devices: Mosaic biological
aortic valve, Vent aspirator, rigid pericardium
aspirator
Perfusion process
Check list: (todo de manera gráfica)
Sutures Hemostats
SURGICAL PROCESS
1.Opening time:
4. Entry in C.E.C: The cardioplegia line is purged. All cannulation lines are connected and the
perfusionist obeys the surgeon's order to enter the patient into the pump.
SURGICAL PROCESS
5. Aortic campleo: The aorta is clamped with the Debakey aorta clamp proximal to the root of the aorta.
6. Cardioplejia: With the help of the perfusionist, the cardioplegia step is done
SURGICAL PROCESS
7. Surgical time:
SURGICAL PROCESS
7. Surgical time:
SURGICAL PROCESS
8. Remove Clamp: The aorta artery is unclamped after checking hemostasis and
possible leaks.
9. C.E.C: Venous cannulas are removed from the venae cavae, tourniquets are removed
and the knots of the purse string are tied.
They pass irrigation to the aortic root
Cardioplegia cannula removed and stitches tied
Arterial cannula is removed
10. Protamine dossis: The surgeon orders a dose of Protamine, which is administered
to the anesthesiologist in the room.
SURGICAL PROCESS
11. CLOSING TIME:
The vena cava and the aorta artery are sutured with 22 mm SH 4-0
polypropylene.
The repair points of the pericardium are cut and removed.
The sternal retractor is removed and hemostasis is checked.
The retractor is placed again and the tubes are passed to the destination.
The sternal retractor is removed, the sternum is sutured with #6 wire
and the subcutaneous cellular tissue is sutured.
Skin suturing and healing