SURGICAL INSTRUMENTATION PROGRAM

TRAINING SURGICAL PLANNING

IQX-FT-003-BUC
Versión: 1

STUDENT NAME: CODE: PRACTICE

Gissel Camila Jerez Muñoz 01190022026 LEVEL: III

TEACHER'S NAME: PRACTICE STAGE: NOTE:

Glenda Instituto del corazón

SPECIALTY: SURGEON: DATE:

Cardiovascular Dr. Fabian Giraldo 09 septiembre 2022

NAME OF PATIENT: MEDICAL HISTORY NUMBER: PATIENT AGE:

Luis Alejandro Mejia Hernandez 13905605 67 Años
SURGICAL PROCEDURE TO PERFORM:
Bethall

SURGICAL INSTRUMENTATION PROCESS

1. PLANNING STAGE:

1.1. Surgical Objective: (Make description)

It consists of a triple cardiac surgery, which entails the replacement of the descending aortic artery, the coronary arterie
are relocated, the aortic valve is placed and the aortic valve is inert.

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

The aortic valve is located in the initial portion of the aor

which is called the aortic root. This is the continuation of t
outflow tract of the left ventricle. The aortic root
related in 2/3 of its circumference to the interventricu
septum and in the remaining 1/3 to the anterior leaf
of the mitral valve. There are 3 aortic valv
(right: R, left: I and noncoronary or posterior NC) th
determine 3 sinuses of Valsalva. When the leaflets gi
way to the arterial portion, we do not find a border zo
between the valvular portion and the tubular porti
that is called the sinotubular junctio
The 2 coronary arteries arise from this are
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1.3. Check list:

MEDICAL EQUIPMENT/ DRUGS AND

SUTURES AND
INSTRUMENTAL DEVICES SOLUTIONS
NEEDLES

 kit ticron 2/0

 prolene 5/0
TF1
 Prolene 4/0
 ptolene 6/0
 Silk 2/0
without needle
 Polyglactin 910
3/0
 surgical wire 5
 pacemaker
thread
 scalpel blade
15
 scalpel blade
11
 bone wax
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ORGANIZATION STAGE:

Arrangement of May tables and reservation (make scheme).

2.2. Patient position (Name and

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

CX IQ

ANES

CX 2

PERFU

2. EXECUTION STAGE:

a) Anesthesia (write the type of anesthesia):

 general anesthesia

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

 inverted t incision in the thorax

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

 Pass umlaut instruments to the surgeon to make the skin incision.

 Transfer to the surgeon elastic apprehension instruments and electrocautery for the incision o
deep tissues such as TCS and pre-sternal fascia of the pectoralis muscle.

 Pass the reciprocating saw to the surgeon to perform the sternotomy, separating the sternal
edges with the Farabeuf retractor

 Pass to the surgeon an electrocoagulation device for hemostasis of the sternal periosteum, and
bone wax for bone marrow.

 Transfer to the surgeon a sternum autostatic retractor to keep the sternum in place together wi
the sternum protectors.

 Transfer to the surgeon vascular elastic apprehension instruments and electrocoagulation

device for opening the pericardium

 Transfer to the surgeon instrumental synthesis and silk suture 0 with a round needle the repair
points of the pericardium

 Pass 2/0 polyester suture and 4/0 polypropylene suture to the surgeon with a round needle so
that the surgeon can make the purse strings in:
 ascending aorta
 right atrium
 aortic root.

 Tourniquet and thread guides are passed to repair tobacco bags, repairing them with kelly
clamp

 Arteriotomies and venotomies are performed, cannulas are inserted

 Fixation of the cannulas is performed with silk 1 precut

 The respective tubing (arterial and venous) is clamped by passing tube caps

 Cardioplegia is performed and clamping instruments are passed for total occlusion of the aort

 Transfer to the surgeon instrumental diaeresis (scalpel, blade 11) and vascular apprehension t
incise the aorta, then Metzembaum-type scissors.

 Pass pericardium suction cannula, to collect blood

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 Pass coronary perfusion cannula, for direct anterograde cardioplegia in the coronary ostia

 Passage of elastic vascular instruments and 4-0 silk suture to repair the walls of the aorta

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

 The surgeon is passed 2-0 vascular polyester suture with felt and a 16 mm needle, the needle
each of the posts and respective repairs, then the following sutures are passed, taking special
care not to repeat the color of the strand.

 It is washed with saline solution and the valve is measured with the gauge approved by the
surgeon and confirmed.

 The nursing assistant is asked to identify the valve device to be planted, and it is confirmed
aloud.

 Pass the valve to the assistant surgeon and he passes polyester2/0 suture with a 16 mm needle
and synthetic instruments.

 Support the surgeon in the passage of sutures in the valve annulus

 After medical device implantation, 4/0 polypropylene suture is passed for aortic closure

 Withdrawal of cardiovascular cannulae

 check foreign body count

 pericardial suture

 installation of drainage system

 hemostasis and closure of the sternum surgical Steel

 skin suture

 heals the patient by cleaning and covering the wound with dressings or adhesive tape

WEEKLY REPORT FORMAT OF TRAINING PRACTICE

SURGERY ASSISTANCE RECORD FORM - TRAINING PRACTICE IQX-FT-024-UDES
 SURGICAL INSTRUMENTATION PROGRAM

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IQX-FT-003-BUC
Versión: 1

STUDENT SIGNATURE: Gissel Camila Jerez Muñoz TEACHING SIGNATURE: __________________________

CONTROL DE CAMBIOS

FECHA DE
VERSIÓN  DESCRIPCIÓN DEL CAMBIO  RESPONSABLE 
APROBACIÓN 

 
Lizeth Guiza
Coordinadora de Prácticas 
00  Versión de Prueba    25/11/2015
 
 
 
Elimina del encabezado la fecha de la  
implementación del formato, según Erika Grandas Ardila 
disposición de la alta dirección consejo
superior.  
Coordinadora de prácticas  
   
01  Eliminación pie de página por 03/08/2022 
modificación en procedimiento control de
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