Cardiac procedures

Question 1

Explain what happens in PCI (aka Angioplasty with stent)

Answer 1

(Smaller procedure compared to CABG)

1. Get access through femoral/ radial/ brachial artery
2. Pass guide wire into relevant artery
3. Dilate with balloon catheter
4. Place stent

Question 2

Explain what happens in CABG

Answer 2

(Major surgery)

1. Make mid-sternal incision
2. Graft blood vessel eg saphenous vein/ internal mammary artery
3. Place blood vessel around blocked area to create alternate path for blood to pass through

Question 3

Explain what happens in thrombolysis for MI

Answer 3

Thrombolytic drug (streptokinase/ alteplase) +

Anticoagulant
heparin/ LMWH/ fondaparineux

Question 4

Main PCI indications

Answer 4

ACS in patients with less complex vessel disease

Patients you want to avoid surgery in

Question 5

Main CABG indications

Answer 5

ACS in patients with complex vessel disease (L main disease/ multi vessel disease/ LV disease

ACS in diabetics

Question 6

Main thrombolysis indications

Answer 6

ACS but unable to do PCI/CABG within 90min

Question 7

Main PCI complications

Answer 7

1. Risk of needing repeated tx
2. Stent thrombosis (MI)
3. Stent stenosis (return of angina)

Question 8

Main CABG complications

Answer 8

Stroke

Question 9

Main thrombolysis complications

Answer 9

1. Risk of re-occlusion (not as ideal as the other interventions)
2. Bleeding risk eg ICH

Question 10

What drugs should be given to someone going for PCI

Answer 10

Heparin OR

LMWH