PROGRAMA DE INSTRUMENTACION QUIRURGICA

PLANEAMIENTO QUIRURGICO FORMATIVA

Versión: 1
IQX-FT-003-BUC
NOMBRE DEL ESTUDIANTE: CÓDIGO: NIVEL DE
DANIELA QUINTERO MONSALVE 01200021025 PRÁCTICA: III

NOMBRE DEL DOCENTE: ESCENARIO DE PRÁCTICA: NOTA:

LIDY HIGUERA ICV

ESPECIALIDAD: CIRUJANO: FECHA:

CARDIOVASCULAR DR. FABIAN OCTUBRE 25

NOMBRE DEL PACIENTE: NÚMERO HISTORIA CLÍNICA: EDAD DEL PX:

73
PROCEDIMIENTO QUIRÚRGICO A REALIZAR:
REEMPLAZO DE VALVULA AORTICA

PROCESO DE INSTRUMENTACIÓN QUIRÚRGICA

1. ETAPA DE PLANEACIÓN:

1.1. Objetivo Quirúrgico: (Hacer descripción)

1.2.
Surgical procedure where the aortic valve of the heart is replaced by an artificial prosthesis can be mechanical or
biological. This procedure is performed when the existing valve has problems such as narrowing that would be aortic
stenosis or aortic insufficiency.

1.2. Anatomía y fisiología: (Hacer gráfico y descripción).

 PROGRAMA DE INSTRUMENTACION QUIRURGICA

PLANEAMIENTO QUIRURGICO FORMATIVA

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1.3. Lista de chequeo

EQUIPOS / FARMACOS Y
INSTRUMENTAL DISPOSITIVOS SUTURAS Y AGUJAS SOLUCIONES
MEDICO
Bone wax for sternal
Extracorporeal Clothing package hemostasis Warm and cold saline
equipment Electrobisturi solution
Suction rubber Silk 0 for pericardium
Accessory Equipment Yankawer Cannula repair Bupivacaine 0.5
HB 11 AND 15
Valve gauges Nelaton probe 8 and 14 Polyester 2/0 needle 25
Asepto syringe mm for arterial and
Sternal separator Tourniquets venous cannula
Rigid pericardial tobacco pouches
Reciprocating saw aspirator
Vent Aspirator Polypropylene 4/0 for
Anterograde cardioplegia, vent and
cardioplegia cannula aorta closure
Chest tube
Ioban Silk 1 precut for fixation
20 cc syringe of cannulae with
18" pink needle tourniquets
Radiopaque gauze
Compresses Silk 4/0 for aortic
Caiman repairs
Skin fields
Arterial cannula eopa Polyester 2/0 needle
Single double venous 16mm kit for valve
cannula fixation
Handles
Coca for sharps Pacemaker thread 2/0
Dermabond
Healing dressings Surgical wire 6 for
Gauze sternal suturing
Tegaderm
Poliglactine 2/0 for
muscle and TCS

Poliglecaprone 3/0 for

skin closure

Pleget for suture

reinforcement
 PROGRAMA DE INSTRUMENTACION QUIRURGICA

PLANEAMIENTO QUIRURGICO FORMATIVA

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2. ETAPA DE ORGANIZACIÓN:

a. Arreglos de mesas de mayo y reserva (realizar esquema).

2.2. Posición del paciente (Nombre y gráfico):

 PROGRAMA DE INSTRUMENTACION QUIRURGICA

PLANEAMIENTO QUIRURGICO FORMATIVA

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2.3. Ubicación del Equipo Quirúrgico (realizar gráfico):

ANESTESIOLOGO

PACIENTE

DER IZQ
CIRUJ AYUDANTE
ANO
IQ

M MAYO
M RESERVA

3. ETAPA DE EJECUCION:

a) Anestesia (escribir el tipo de anestesia):

GENERAL

b) Incisión (escribir el tipo de abordaje y el nombre de la incisión):

Esternotomy
 PROGRAMA DE INSTRUMENTACION QUIRURGICA

PLANEAMIENTO QUIRURGICO FORMATIVA

Versión: 1
IQX-FT-003-BUC

c) Proceso Quirúrgico (Describir los pasos principales de la técnica médico-quirúrgica con el instrumental a usar).

- Make a skin incision with a 15 scalpel, hemostasis with electro and separated with Farabeuf for better visualization -
Perform sternotomy with the reciprocating saw from the sternal notch to the xiphoid process Hemostasis of the
sternum is performed with electroscalpel and bone wax Protectors are placed with pieces of line and then the external
separator The pericardium is opened. With 2/0 polyester we make the purses for arterial cannulation in the aorta and
venous cannulation in the right atrium With polypropylene, the purse for the vent aspirator is made in the right upper
pulmonary vein and tourniquets are placed, which are repaired with Kelly clamp. The corresponding cannulation is
performed in the aorta and the cannulas are fixed with silk. The tube is clamped and the cannulas are purged. Perform
venous cannulation by expanding the incision with t metzembaum The extracorporeal circuit is finished connecting
After performing all the cannulations, the total occlusion vascular clamp is prepared to clamp the aorta. The aorta is
incised and cardioplegia is passed through the coronary ostia The walls of the aorta are repaired with 4/0 silk
The calcified valves are removed with allix forceps and placed in a pathology jar. Washing with saline solution is
performed to remove all the little pieces of calcium that will remain. Wet valve meters are passed with saline solution
The valve is chosen and mounted on the support to be delivered to the surgeon. 16 mm 2/0 polyester is mounted and
repaired on the valve without repeating colors After implanting the valve, the aorta is sutured with 4/0 prolene and
aeration is performed. Warm saline solution is prepared to level the patient's warming levels and the aorta is
unclamped. It goes off the pump slowly The pacemaker wire is placed and positioned in the atrium or ventricle as the
surgeon sees fit. The tube is placed in the chest, fixed and the Nelaton 14 probe is inserted for aspiration. A count of
gauze compresses and others is carried out. The surgical wire 6 is prepared mounted on the wire needle holder and a
Rochester on the tip Muscle and tcs are closed with vicryl and skin with monocryl. The patient is cured with sealant and
dressings.

FORMATO DE INFORME SEMANAL DE LA PRACTICA FORMATIVA

FORMATO RECORD DE ASISTENCIA A CIRUGIA - PRACTICA FORMATIVA
IQX-FT-024-UDES

FIRMA ESTUDIANTE: ________________________ FIRMA DOCENTE: __________________________

 PROGRAMA DE INSTRUMENTACION QUIRURGICA

PLANEAMIENTO QUIRURGICO FORMATIVA

Versión: 1
IQX-FT-003-BUC