2C: Cardiac Surgery

Question 1

What does PTCA stand for?

Answer 1

Percutaneous Transluminal Coronary Angioplasty

Question 2

Describe a PTCA

Answer 2

Catheter to the lesion or plaque, then balloon is inflated to compress against the arterial wall

Question 3

When is PTCA used?

Answer 3

Moderate atherosclerosis of 1-2 arteries

Question 4

When is a stent placed?

Answer 4

After a PTCA to maintain luminal diameter

Question 5

What are precautions following PTCA or stent placement?

Answer 5

Bedrest if femoral, minimal if radial

Question 6

What should you do when initiating activity following PTCA or stent placement?

Answer 6

Follow vitals and EKG closely. Watch for signs of intolerance to activity

Question 7

Describe CABG

Answer 7

Graft artery is harvested and attached above and below the area of atherosclerosis to allow for blood to areas of the heart through coronary arteries

Question 8

When is CABG used?

Answer 8

Moderate to severe CAD in one or more vessels

Question 9

What are common grafts used for CAGB?

Answer 9

LIMA (left internal mammillary artery), saphenous vein, radial artery, RIMA

Question 10

What is best option for a CAGB graft and why?

Answer 10

LIMA for best long-term results due to less resclerosis

Question 11

What are limitations to using the saphenous veins for CABG, and how are they minimized?

Answer 11

One way valves can create issues, vein is turned inside out to prevent issues

Question 12

What are the initial precautions following CABG?

Answer 12

Bedrest the day of surgery

Question 13

What are the precautions following bed rest for a CABG?

Answer 13

UE and activity restrictions from surgeon, follow vitals and EKG, watched for signs of exercise intolerance

Question 14

What is Electrophysiological Ablation?

Answer 14

Local spot causing arrhythmia, ablation to cauterize the tissue and stop electrical impulse

Question 15

Describe atrial or ventricular septal defect repair

Answer 15

Correction of deformity, usually congenital or from tumor

Question 16

What valve are commonly replaced?

Answer 16

Aortic or mitral followed by tricuspid or pulmonary

Question 17

What will lead to a valve being replaced?

Answer 17

Insufficiency or stenosis

Question 18

What are the precautions following a septum repair or valve replacement?

Answer 18

Bed rest day of surgery. Day 1 following precautions and monitoring vitals

Question 19

What are the two types of heart transplant, and which is more common?

Answer 19

Orthotopic (most common) and Heterotopic

Question 20

Describe an orthotopic heart transplant

Answer 20

Original heart is removed and replaced with new one. Part of bilateral atria are left where new heart is grafted to

Question 21

Describe a heterotopic heart transplant

Answer 21

Piggyback - both hearts remain. Transplant is placed on opposite side and attached to original atria-atria and ventricle-ventricle

Question 22

What are the precautions following a heart transplant?

Answer 22

Bed rest day of surgery. Day 1 following precautions and monitoring vitals.

Follow any exposure restrictions due to immunosuppressants