Capítulo 31: 30.Under shock
Everything was prepared for the operation, now in front of the operation theatre, Shounak and Mrs. Kiara were talking to Mr.Ankush and telling him to be strong .Then he was escorted inside the OT .D talked to them about procedure and duration of surgery and also went inside .
Outside, Shounak was telling his mother everything will be ok .Mrs. Sen was praying for her husband .
D told her anaesthesiologist to sedate the patient and prep for surgery and also start cooling system .
She wore the surgical gown and went inside the OT. They had to cool down the body temperature, in order to lower metabolic rate and lessen the oxygen utilisation by body .
They had to temporararily arrest the heart and after anterior sternotomy start cardiopulmonary bypass through ascending aorta if it is in good condition.
She had successfully done cardiopulmonary bypass and reached the arch . The aneurysm was quite big with diameter 6 cm .
After clamping the the distal and proximal ends , she started dissecting arch . After removing the mural thrombi, she observed the condition of aorta and it's branches. It was quite bad she had to dissect larger part of aorta and also it's branches .
She proceeded with anastomosis after dissecting the aorta and adding gauze .
She had to cut almost 5 cm of all branches due to the damage .
After the anastomosis was done , she removed the clamp and started the blood flow .
But the arch aorta was in bad condition , even after anastomosis was done perfectly, the arch of aorta was torn in distal part and there was massive blood loss . Patient was under shock .
She ordered to infuse blood repeatedly which was collected through suction due to shortage of blood and also saline .
"Apply more pressure on blood pack. Infuse at full speed ." She calmly ordered .
She clamped the vessel again and dissected the damaged part and tied it again . She did it very fast , as she has to avoid the brain damage due to lack of blood supply .
If brain doesn't get new blood within 8 min it will start undergoing ischaemic changes . If it is delayed more , patient may end up brain dead .
She then checked again for any leakage of blood . It was clean . Then she removed the cannula from ascending aorta and closed up .
PENSAMENTOS DOS CRIADORES 
That_dimple_girl
That_dimple_girl Ascending aorta -blood vessel emerging from
heart and going upwards
Mural thrombi - Full thickness blood clot in
blood vessel
Sternotomy -Cutting of bone sternum
Sorry ! Sorry ! Sorry !
I wasn't able to update for quite a while because, it is now festive season and there are so many to be prepared and I have exams right after it is over . So plz , understand my situation . I will update whenever I have time so plz understand me .
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