Name of the Procedure:

Transection of Pulmonary Artery with Cardiopulmonary Bypass

Summary

Transection of the pulmonary artery with cardiopulmonary bypass is a surgical procedure that involves cutting and repairing the main artery that transports blood from the heart to the lungs. The heart-lung machine is used to take over the function of the heart and lungs during the surgery.

Purpose

The procedure is primarily performed to correct congenital heart defects, such as pulmonary artery stenosis, or to address other serious conditions affecting the pulmonary artery. The goals are to restore normal blood flow from the heart to the lungs and to improve overall cardiac function.

Indications

• Severe pulmonary artery stenosis
• Congenital heart defects involving the pulmonary artery
• Pulmonary artery aneurysm or other structural abnormalities
• Failure of previous treatments or surgeries involving the pulmonary artery
• Symptoms may include shortness of breath, chest pain, or fatigue.

Preparation

• Patients may need to fast (not eat or drink) for several hours before the procedure.
• Certain medications may need to be adjusted or stopped as advised by the healthcare provider.
• Preoperative tests such as blood tests, echocardiograms, or cardiac catheterization might be needed.
• A consent form will need to be signed after discussing risks and benefits with the surgeon.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the chest to access the heart and pulmonary artery.
3. The heart-lung machine is connected to take over the heart’s pumping and oxygenating functions.
4. The pulmonary artery is carefully transacted (cut) and any necessary repairs or reconstructions are made.
5. Once repairs are complete, the heart-lung machine is gradually weaned off as the heart resumes its normal function.
6. The chest incision is closed and the patient is moved to the recovery area.

Duration

The procedure typically takes 3 to 6 hours, depending on the complexity of the repair needed.

Setting

The surgery is performed in a hospital operating room equipped with advanced cardiothoracic surgical tools.

Personnel

• Cardiothoracic surgeons
• Anesthesiologists
• Surgical nurses
• Perfusionists (to operate the heart-lung machine)
• Cardiac specialists

Risks and Complications

• Infection
• Bleeding
• Blood clots
• Stroke or heart attack
• Arrhythmias (irregular heartbeats)
• Complications from anesthesia
• Potential need for a prolonged hospital stay or additional procedures

Benefits

• Improved blood flow from the heart to the lungs
• Decreased symptoms such as shortness of breath and fatigue
• Enhanced overall heart function
• Potentially life-saving correction of congenital or acquired heart defects

Recovery

• Patients will be monitored in the Intensive Care Unit (ICU) for the first 24-48 hours.
• Pain management and close monitoring of cardiovascular functions.
• Gradual increase in activity levels as instructed by the healthcare team.
• Follow-up appointments to monitor recovery and cardiac function.
• Full recovery might take several weeks to months, with specific restrictions on physical activity during this time.

Alternatives

• Medical management with medications to control symptoms
• Less invasive procedures like balloon angioplasty or stenting, though these may not be suitable for all conditions
• Risks and effectiveness should be discussed with a healthcare provider to determine the best course of action.

Patient Experience

• During the procedure, the patient will be under general anesthesia and will not feel any pain.
• Postoperative pain and discomfort can be managed with prescribed medications.
• Patients might experience fatigue and need assistance with daily activities for a period post-surgery.
• Emotional support and counseling may be beneficial to cope with recovery and lifestyle changes.