This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Basics of Vascular Surgery
Soumya Ranjan ParidaSum Nursing College
Chronically Blocked Artery
Principles of Vascular Closureheart is a (bent) vessel !!
•Full thickness •Angle to center• ‘inside out’ on artery•Posterior Anterior / Distal Proximal•Sutures Under vision •Avoid narrowing
endothelium is an ‘organ’ not a passive membrane
Principles of suturing a vessel
Suture angle to center
Calcified Vessel : Needle ‘Inside - Out’
Needle puncture Occupied by strand Needle hole bleed
beveled•Suture decided•Graft held away, heel sutures taken•Graft lowered, sutures tightened•Suturing continued on one/ either side•Sutures loosened – shunt removed – tied•Clamp released , bleeding checked
Types of anastomosis A: end to side B: side to side C: sequential