2C: Cardiac Surgery Flashcards
What does PTCA stand for?
Percutaneous Transluminal Coronary Angioplasty
Describe a PTCA
Catheter to the lesion or plaque, then balloon is inflated to compress against the arterial wall
When is PTCA used?
Moderate atherosclerosis of 1-2 arteries
When is a stent placed?
After a PTCA to maintain luminal diameter
What are precautions following PTCA or stent placement?
Bedrest if femoral, minimal if radial
What should you do when initiating activity following PTCA or stent placement?
Follow vitals and EKG closely. Watch for signs of intolerance to activity
Describe CABG
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
When is CABG used?
Moderate to severe CAD in one or more vessels
What are common grafts used for CAGB?
LIMA (left internal mammillary artery), saphenous vein, radial artery, RIMA
What is best option for a CAGB graft and why?
LIMA for best long-term results due to less resclerosis
What are limitations to using the saphenous veins for CABG, and how are they minimized?
One way valves can create issues, vein is turned inside out to prevent issues
What are the initial precautions following CABG?
Bedrest the day of surgery
What are the precautions following bed rest for a CABG?
UE and activity restrictions from surgeon, follow vitals and EKG, watched for signs of exercise intolerance
What is Electrophysiological Ablation?
Local spot causing arrhythmia, ablation to cauterize the tissue and stop electrical impulse
Describe atrial or ventricular septal defect repair
Correction of deformity, usually congenital or from tumor
What valve are commonly replaced?
Aortic or mitral followed by tricuspid or pulmonary
What will lead to a valve being replaced?
Insufficiency or stenosis
What are the precautions following a septum repair or valve replacement?
Bed rest day of surgery. Day 1 following precautions and monitoring vitals
What are the two types of heart transplant, and which is more common?
Orthotopic (most common) and Heterotopic
Describe an orthotopic heart transplant
Original heart is removed and replaced with new one. Part of bilateral atria are left where new heart is grafted to
Describe a heterotopic heart transplant
Piggyback - both hearts remain. Transplant is placed on opposite side and attached to original atria-atria and ventricle-ventricle
What are the precautions following a heart transplant?
Bed rest day of surgery. Day 1 following precautions and monitoring vitals.
Follow any exposure restrictions due to immunosuppressants
