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Planemientos RVM 1
Planemientos RVM 1
1. PLANNING STAGE:
It is a surgical procedure performed to restore blood flow to the heart muscle (myocardium) that may be compromised
due to blockages in the coronary arteries.
Left Anterior Descending (LAD) Artery: Extends to the front of the heart and supplies blood to the majority of the
interventricular septum and the anterior and lateral portions of the left myocardium.
Right Marginal Artery: A branch originating from the RCA, supplying blood to the right lateral side of the heart.
Circumflex Artery:
Circumflex Artery: A branch of the left coronary artery, coursing around the back of the heart.
Obtuse Marginal Artery: A branch of the circumflex artery supplying blood to the inferior part of the left ventricle.
• As it approaches the groin, it connects with the femoral vein, one of the major veins in the deep venous system.
• As it ascends towards the thigh, it connects with the popliteal vein, another important deep vein.
SURGICAL INSTRUMENTATION PROGRAM
2. ETAPA DE ORGANIZACIÓN:
3. ETAPA DE EJECUCION:
RTA: Sternotomy
c) Proceso Quirúrgico (Describir los pasos principales de la técnica médico quirúrgica con el instrumental a usar).
Instrumental pass of Dieresis Scalpel handle #3 Scalpel blade #15 for the surgeon to make the incision of the
tissues.
Pass to the surgeon instruments of elastic apprehension and electrocoagulation elements in 40 for the
incision of deep tissues (subcutaneous cellular tissue and muscle).
For manual separation, pass the Farabeuf and Senn type separators to the surgeon.
Go to the surgeon with vascular-type elastic apprehension instruments, umlaut instruments for dissection of
the saphenous vein and its tributaries.
For ligation and hemostasis, use ligature clip forceps and the corresponding clip cartridge according to the
caliber of the vessel.
To extract the venasafena, pass cystic type hemostasis instruments, scissors-type umlaut instruments,
Adson Kelly clamp, and pre-cut silk 1.
Prepare umlaut instruments, ligation clips, and baby and mosquito-type hemostatic forceps to dilate the distal
end of the saphenous vein.
Prepare arteriotomy cannula and 10ml syringe to cannulate and dilate the saphenous vein with heparinized
solution and prepare hemo clip according to the caliber of the vessel for ligation of loose tributaries.
VASCULAR TIME
SURGICAL PROCEDURE
Prepare vascular-type elastic apprehension instruments, synthesis and 2/0 polyester suture material so that
the surgeon can make the tobacco pouches in:
-Ascending Aorta (purse of tobacco for arterial cannulation).
-Right atrium (tobacco bag for single venous cannulation).
-Prepare 4/0 polypropylene so that the surgeon can make the tobacco bags in:
-Aorta root (purse of tobacco forcannulation of antegrade cardioplegia by aorta root.
Prepare a tourniquet and/or thread guide to remove the tobacco pouches made by the surgeon, repairing
them with Kelly-type hemostatic instruments.
Prepare the appropriate cannulas for the patient's perfusion as appropriate.
-Go to the mb#7 hb#11 type umlaut instrument surgeon to perform the arteriotomy to perform the
corresponding cannulation.
-Prepare pre-cut silk 1 for fixation of the placed cannulas by passing them into the surgeon's hand.
- Prepare tube clamp and gauze for purging the arterial cannula.
-Go to the diaeresis instrument surgeon type mb#7 hb#11 to make the incision in the right atrium.
-Pass long demetzembaum scissors to the surgeon to expand the incision and perform the corresponding
cannulation.
-Prepare pre-cut silk 1 for fixation of the placed cannulas by passing them in the surgeon's hand.
Prepare suitable connectors for proper connection of the cannula to the extracorporeal circuit.
-Pass the antegrade cardioplegia cannula to the surgeon for its respective cannulation.
-Pass to the surgeon protected mosquito hemostasis instruments to purge the cannula
-Prepare total occlusion vascular clamp for the surgeon to perform aortic clamping
SURGICAL INSTRUMENTATION PROGRAM
CORRECTION TIME
SURGICAL PROCEDURE
Provide the surgeon with compresses and gauze in order to position the heart and expose the arteries to be
revascularized.
Go to the instrumental surgeon with umlaut, microvascular elastic apprehension to perform the coronary
arteriotomy and its prolongation.
Prepare the 7/0 and/or 8/0 gauge polypropylene synthesis and suturing instruments for the surgeon to
perform distal anastomoses of the vein graft to the coronary artery.
For better exposure of the surgical field at the anastomosis site, prepare CO2 aeration with a suction line and
cannula.
To test the effectiveness of vasocoronary, prepare a syringe with saline solution.
If it is necessary to reinforce the suture, prepare microvascular synthesis instruments, microvascular
dissection forceps and suture.
Prepare umlaut instruments, elastic vascular apprehension instruments and bulldog clamp, to cut the free
saphenous graft and prepare the vessel for the proximal anastomosis.
For proximal anastomoses, prepare umlaut instruments mb#7 hb#11 and intra-aortic punch to prepare the
aorta at the anastomosis site of the new coronary vessel.
Prepare the 6/0 gauge polypropylene synthesis and suturing instruments so that the surgeon can perform the
proximal anastomoses of the graft to the aorta.
CLOSING TIME
SURGICAL PROCEDURE
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