Clinical Case 3

"Aortic valve replacement plus

myocardial revascularization"
 PATIENT
INFORMATION
Name: Abelardo Gonzales Ruiz
ID: 2054825
Weight: 75 kg
Height: 1. 75 cm
Blood Type: AB+
Results: HIV (-), Hepatitis B (-)
Age: 85 years old
FE: 66%
EPS: ecopetrol
Diagnosis
aortic valve stenosis plus coronary
artery disease

Procedure:
aortic valve replacement and
myocardial revascularization
 The process begins

1. review medical history

2. humanized treatment is
made with the patient
3. He is asked how the surgical
bath was and what antiseptic
was used
 step by step
procedure
5. Performs the cannulation, according
1. asepsis and antisepsis of the
to the surgeon's preference, the use of
patient
suction ventilation and retrograde
2. Longitudinal lower limb incision
cardioplegia.
3. section of the saphenous vein
6. If the sinus venosus is not
to perform the coronary bypass
cannulated for retrograde perfusion,
4. inverted T-incision over the
pass a metal needle to the surgeon for
thorax
indirect antegrade cardioplegia

(surgeon's choice)
7. Pass the umlaut instruments (scalpel
blade 11) and vascular grasping
instruments to the surgeon to incise
the aorta, then pass the scissors.
8. Pass the suction cannula of the
machine to collect the blood.
9. Pass 4-0 silk for repair of aortic walls
10. Pass vascular grasping
forceps and scissors for aortic
valve dissection and removal.
11. Note that when the valve is
calcified, the surgeon places a
medium-moist gauze pad in the
cavity, removes the valve using
allix forceps, scissors, and
vascular grasping forceps.
 12. The surgeon passes the surgeon a 2-0
vascular needle polyester suture with or without
felt (at the surgeon's discretion) of 16mm in each
of the posts and respective repair, then passes
the following sutures, taking special care not to
repeat the color of the thread, the change of this
sequence will be given by order of the surgeon.
13. Proceed to measure the valve with the sizer
approved by the surgeon and confirmed.
14. If the valve to be implanted is biological, wash
it according to the valve device washing protocol
 17. Perform the completion time
15. Support the surgeon in the
steps: patient decannulation,
passage of the sutures in the
hemostasis review, pericardial
valve annulus.
closure, pericardial muscle and fat
16. After implantation of the
closure, sternum closure, and skin
medical device, pass the closing
suture (4-0 prolene 4-0 round closure.
needle 16 mm with pleat) 18. healing
Complications that the patient
may suffer after surgery

Patient Abelardo had the following

complications:
1. atrial tear
2. sinus venosus rupture
¡THANKS!
BY
Gissel Camila Jerez Muñoz