How to establish cardiopulmonary bypass

summary

The establishment of cardiopulmonary bypass is only a part of human surgery, which is mainly divided into two parts: in vivo surgery and in vitro surgery. Let's take a look at how to establish cardiopulmonary bypass.

How to establish cardiopulmonary bypass

First, the gap between the aorta and the pulmonary artery was separated, and the ascending aorta was ligated. The ascending aorta was pulled to the left to expose the medial side of the superior vena cava, and the right angle clamp was used to bypass the posterior ligation along the medial side of the superior vena cava. The inferior vena cava forceps were wrapped around the inferior vena cava in the same way.

Secondly, at the distal end of the ascending aorta, two concentric purse string sutures were made with No. 7 suture, which did not penetrate the blood vessels, but sutured to the adventitia of the aorta, with one opening on the left and one on the right. Put the purse string into the hemostat for hemostasis and fixation during intubation. The adventitia of the central part of the purse was excised. After heparin (3mg / kg) was injected into the right atrial appendage, a small round (sharp) blade knife was used to cut an incision slightly smaller than the diameter of the artery cannula in the middle of the pouch. At the same time, the artery cannula was put into the ascending aorta incision. The two Purse string hemostatic devices were tightened immediately, and the artery cannula and the hemostatic device were fixed together with thick silk thread. Finally, the arterial cannula was fixed on the edge of the incision or the petiole of the distractor, and the cannula was connected with the artificial cardiopulmonary machine.

Finally: a purse string was sewn on the right atrial appendage and the right atrium respectively, and a hemostat was put on it, then the incision was made, the superior and inferior vena cava cannula was inserted (generally, the superior vena cava tube of the atrial appendage was inserted first), and the hemostat was tightened. Thick silk thread was used to encircle the auricle and atrial wall 2-3mm below the incision of ligation, and the ligation thread was used to fix the upper and lower lumen cannula to prevent slipping off. The upper and lower cannulas were connected with the artificial heart lung machine.

matters needing attention

The prevention of infection should begin before operation, be more strict than during operation, and then after operation. All transfusion channels should be kept sterile to prevent contamination. In the postoperative fever phenomenon, can use physical cooling or antipyretic drugs to solve.