Cardiac surgery

Question 1

List one indication for CABG?

Answer 1

1. > 50% stenosis of left main stem
2. 2-3 main coronary arteries diseased= triple vessel disease
3. poor ventricular function associated with multi-vessel disease

Question 2

Which drug must be administered prior to performing CABG?

Answer 2

heparin

Question 3

How is heparin reversed?

Answer 3

protamine

Question 4

What is cardioplegia?

Answer 4

K+ rich solution that arrests the heart in order to allow surgery

Question 5

Where are grafts taken from for CABG?

Answer 5

venous- long saphenous vein

arterial- internal thoracic

Question 6

List three post-operative complications of heart surgery

Answer 6

bleeding
arrhythmias
poor cardiac output
stroke
wound infections
mortality

Question 7

List one indication for aortic valve replacement

Answer 7

1. Severe AS with symptoms/reduced exercise tolerance
2. Severe AF with EF<50%
3. Mod-severe if undergoing other cardiac surgery

Question 8

Is the aortic valve repaired or replaced?

Answer 8

aortic valve is only ever replaced (mitral valve can be repaired)

Question 9

What are the differences between metallic and tissue valves?

Answer 9

metallic

• lifelong
• durable
• less risk of repoperation
• lifelong anticoagulation

tissue

• 10-15 year lifespan
• susceptible to degeneration
• no noise
• higher risk of re-op
• vegetations
• no lifelong operations

Question 10

When is transcutaneous pacing indicated versus epicardial?

Answer 10

epicardial= post surgery
transcutaneous= any slow rate where patient is symptomatic. Quick and easy