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STUDENT NAME: CODE: PRACTICE

SILVIA CRISTINA MONSALVE VEGA 01200021005 LEVEL: III

TEACHER'S NAME: PRACTICE STAGE: NOTE:

GLENDA ICB

SPECIALTY: CX SURGEON: DATE:

CARDIOVASCULAR 02/06/2023

NAME OF PATIENT: MEDICAL HISTORY NUMBER: PATIENT AGE:

SURGICAL PROCEDURE TO PERFORM:

AORTIC COARCTATION AND ABERRANT SUBCLAVIAN ARTERY

SURGICAL INSTRUMENTATION PROCESS

1. PLANNING STAGE:

1.1. Surgical Objective: (Make description)

Perform surgical correction of aberrant aortic and subclavian coarctation, congenital defects of the
baby
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1.2. Anatomy and physiology: (Make graph and description)

HEART ANATOMY

The heart consists of four chambers:

The atria: are the two upper chambers, which receive blood.
The ventricles: are the two lower chambers, which discharge blood.
A wall of tissue called the septum separates the left and right atria, and the left and right ventricles. Valves separate the
atria from the ventricles.

The walls of the heart consist of three layers of tissue:

✓ Myocardium: This is the muscle tissue of the heart.

✓ Endocardium: This tissue lines the inside of the heart and protects the valves and chambers.
✓ Pericardium: a thin protective layer that surrounds the other parts.
✓ Epicardium: This protective layer consists mainly of connective tissue, and forms the innermost layer of the
pericardium.

FUNCTION OF THE HEART

The right side of the heart receives deoxygenated blood and sends it to the lungs.
The right atrium receives deoxygenated blood from the body through veins called the superior and inferior vena cava.
These are the largest veins in the body.
The right atrium contracts, and blood passes into the right ventricle.
Once the right ventricle is full, it contracts and pumps blood to the lungs through the pulmonary artery. In the lungs, the
blood picks up oxygen and discharges carbon dioxide.

The left side of the heart receives blood from the lungs and pumps it to the rest of the body.
Freshly oxygenated blood returns to the left atrium via the pulmonary veins.
The left atrium contracts, pushing blood into the left ventricle.
Once the left ventricle is full, it contracts and pushes blood back to the body through the aorta.
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HEART VALVES
The heart has four valves to ensure that blood only flows in one direction:

Aortic valve: located between the left ventricle and the aorta.
Mitral valve: located between the left atrium and the left ventricle.
Pulmonary valve: located between the right ventricle and the pulmonary artery.
Tricuspid valve: located between the right atrium and the right ventricle.

Blood vessels
There are three types of blood vessels: arteries, veins, and capillaries.

The aorta is the first segment of the systemic arterial circulation, originating directly from the left ventricle of the heart.

The aortic arch is the second segment of the aorta that begins at the branch point of the brachiocephalic trunk, posterior
to the second right sternocostal joint. On its course, the aortic arch rotates upward and backward to the left, anterior to
the bifurcation of the trachea.

Branches
Three branches emerge from the convexity of the aortic arch; the brachiocephalic trunk, the left common carotid artery,
and the left subclavian artery.
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1.3. Check list:

MEDICAL EQUIPMENT/ DRUGS AND

SUTURES AND
INSTRUMENTAL DEVICES SOLUTIONS
NEEDLES
-Pediatric -Overall package -Polypropylene 7/0 -Lidocaine without
extracorporeal basket -Scalpel blade # 11-15 anastomosis epinephrine
-Clamp -sharp container -Polypropylene 5/0 to -Saline solution
-Self-static sternal -Clips 100-200 close ducts -Heparin
retractor -jovan -Polyglactin 910 3/0
-castroviejo needle -electrosurgical Subcutaneous cell tissue
holder -gauze -Monocryl 4/0 skin
-garter clip pliers -compresses -2/0 polyester for ostomy
-cokes -rubber suction -Clip yellow 100
-malleable valves -aseptosyringe -Clip blue 200
-Gloves -Silk 4/0 pericardium
-nelaton probe -Polyglactin 910 0
-handlebars Intercostal closure
-dermabond
-Tegader
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2. ORGANIZATION STAGE:

a. Arrangement of May tables and reservation (make scheme).

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6
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2.2. Patient position (Name and graphic):

Lateral decubitus position

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

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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):

✓ Thoracotomy incision

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

-Thoracotomy incision, incise with blade #15

-They separate with farabeuf and continue to affect with electrosurgical unit

-They place a self-static separator

-Repairs the pericardium silk 4/0

-Dissect the subclavian artery and the ductus and place collateral clips

-Ligate the ductus with 5/0 polypropylene

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-They give you heparin

-Clips the aberrant artery and cuts

-The aorta is clamped with a clamp.

-Cut the coarctation of the aorta to make the anastomosis

-Aortic anastomosis is performed with 7/0 vascular polypropylene

-The aorta is unclamped to verify that there is no bleeding.

-Proceed to close the pericardium with 4/0 silk

-They make an incision to place Blake's drain and fix it with 2/0 polyester

-Perform intercostal closure with polyglactin 910 0

-Then close fascia with polyglactin 910 3/0

-Infiltrate with lidocaine without epinephrine

-Skin is closed with monocryl 4/0

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WEEKLY REPORT FORMAT OF TRAINING PRACTICE

SURGERY ASSISTANCE RECORD FORM - TRAINING PRACTICE IQX-FT-024-UDES

STUDENT SIGNATURE: SILVIA MONSALVE 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 documentos y registro.