SURGICAL INSTRUMENTATION PROGRAM

SURGICAL PLANNING
TRAINING PRACTICE Version: 1
IQX-FT-003-BUC

STUDENT NAME: CODE: LEVEL OF

Juan Sebastian Rincon Martinez 01190022014 PRACTICE: III

TEACHER'S NAME: PRACTICE SCENARIO: NOTE:

Glenda Pabon Bucaramanga Heart Institute
(Fosunab)
SPECIALTY: SURGEON: DATE:
Cardiovascular Surgery Dr. Fabian Giraldo August 31, 2022

PATIENT'S NAME: MEDICAL RECORD NUMBER: PX AGE:

Nidia Esther Rangel Navarro 63459829 51 Years Old
SURGICAL PROCEDURE TO BE PERFORMED:
Aortic Valve Replacement

SURGICAL INSTRUMENTATION PROCESS

1. PLANNING STAGE:

1.1. Surgical Objective: (Make description)

It is the replacement of the aortic heart valve by a mechanical or biological prosthesis, the selection of which is
determined by considerations related to the frequency of thromboembolism, need for anticoagulation, durability of the
prosthesis, hemodynamic characteristics of the valve, socioeconomic status of the patient and surgeon's preference.

Aortic valve replacement may be due to congenital or acquired disease, among the congenital ones is the bicuspid valve
and among the acquired ones are insufficiency and stenosis.

1.2. Anatomy and physiology: (Make graphic and description)

The mechanical prosthesis is
currently constituted by bivalve
lenticular discs or two discs, the ring
is metallic and the two leaflets or
discs are made of graphite carbon,
impregnated with tungsten coated
with pyrolytic carbon.

Biological valves were developed

with the intention of obtaining a
valve with more physiological
characteristics, which was less
thrombogenic and therefore did not
require the imperative use of
anticoagulant agents, currently on
the market there are a variety of
valves such as pericardial valves
anthologous, homograft valves,
porcine valves, bovine pericardial
valves, unsupported bioprosthesis.
 SURGICAL INSTRUMENTATION PROGRAM

SURGICAL PLANNING
TRAINING PRACTICE Version: 1
IQX-FT-003-BUC

1.3. Checklist:
 SURGICAL INSTRUMENTATION PROGRAM

SURGICAL PLANNING
TRAINING PRACTICE Version: 1
IQX-FT-003-BUC

2. ORGANIZATION STAGE:

a. May table arrangements and reservation (make outline)

 SURGICAL INSTRUMENTATION PROGRAM

SURGICAL PLANNING
TRAINING PRACTICE Version: 1
IQX-FT-003-BUC

2.2. Position of the patient (Name and chart):

Supine Decubitus

2.3. Location of the Surgical Team (make graphic):

 SURGICAL INSTRUMENTATION PROGRAM

SURGICAL PLANNING
TRAINING PRACTICE Version: 1
IQX-FT-003-BUC

3. EXECUTION STAGE:

a) Anesthesia (write the type of anesthesia):

General Anesthesia

b) Incision (write the type of approach and the name of the incision):

Incision for sternotomy, minimal internal or medial Incisions.

c) Surgical Process (Describe the main steps of the medical-surgical technique with the instruments to be used).

1. Perform setup time steps

2. Perform the opening time steps

3. Verify with the surgeon, if necessary, the femoral opening.

4. Perform the vascular timing steps

5. Note that the cannulation will be unique, according to the surgeon's taste the use of vent suction and retrograde
cardioplegia.

6. If the venous sinus is not cannulated for retrograde perfusion, pass to the surgeon metal needle to give indirect
anterograde cardioplegia (surgeon's choice)

7. Pass to the surgeon the instruments of dieresis (scalpel blade 11), and vascular apprehension to incise the aorta,
then pass the tissue scissors.

8. Pass the suction cannula from the machine to collect the blood.

9. Pass coronary perfusion cannula, for direct anterograde cardioplegia in the coronary ostium.

10. Pass 4-0 silk for repair of aortic walls

 SURGICAL INSTRUMENTATION PROGRAM

SURGICAL PLANNING
TRAINING PRACTICE Version: 1
IQX-FT-003-BUC

11. Pass vascular grasping forceps and scissors for dissection and removal of the aortic valve.

12. Note that when the valve is calcified, the surgeon places a half wet gauze in the cavity, removes the valve by
applying allix forceps, scissors and vascular grasping forceps.

13. The surgeon passes to the surgeon 2-0 vascular needle polyester suture with or without plush (surgeon's taste) of
16mm in each of the posts and respective repair, then passes the following sutures, taking special care not to repeat
the color of the thread, the change of this sequence will be given by the surgeon's order.

14. Wash with saline solution, remember to place an extension to the aseptic syringe.

15. Proceed to measure the valve with the meter approved by the surgeon and confirmed.

16. The valvular device to be implanted is asked to the nurse assistant and confirmed aloud.

17. If the valve to be implanted is biological, wash it according to the protocol for washing valve devices (MC. 23-???).

18. Pass the valve to the assistant surgeon.

19. Support the surgeon in the passage of the sutures in the valve annulus.

20. After implantation of the medical device, pass closing suture (4-0 prolene 4-0 16mm round needle with pleget)

21. Enlist root suction (surgeon's discretion).

22. When removing the suction from the vent, make sure to introduce SSN in the right superior vein, so as not to create
air bubbles.

23. Perform the steps of the completion time

 SURGICAL INSTRUMENTATION PROGRAM

SURGICAL PLANNING
TRAINING PRACTICE Version: 1
IQX-FT-003-BUC

FORMATIVE PRACTICE WEEKLY REPORT FORMAT FORMATO RECORD DE ASISTENCIA A

SURGERY - TRAINING
PRACTICE IQX-FT-024-UDES

STUDENT SIGNATURE: TEACHER'S SIGNATURE:

CHANGE CONTROL

VERSIÓN DESCRIPTION OF THE CHANGE RESPONSIBLE APPROVAL DATE

00 Trial Version Lizeth Guiza Páez 25/11/2015

Coordinadora de practicas

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implementation of the format, according to the
disposition of the top management superior Erika Grandas Ardila
council. Coordinadora de practicas

01 10/05/2021
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document control and registration procedure..
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