Cardiac Surgery

Question 1

Patient criteria for CABG?

Answer 1

Adequate:
Lung function
Mh
Hepatic function
Ascending aorta ok
Distal coronary targets ok
LV EF >20%

Question 2

Conduits for cabg?

Answer 2

Reversed saphenous vein
Internal mammary arteries
Radial arteries

Question 3

Sternotomy related problems?

Answer 3

Wire infections
Painful wires
Sternal dehiscence
Sternal mal union

Question 4

Long term outcomes post cabg?

Answer 4

50% have no cardiac problems 10 years later
The other half have only minor problems and can be controlled medically

5% may need repeat cabg

Question 5

What pathogens cause endocarditis?

Answer 5

Strep Viridans
S. Aureus

Question 6

What happens in cardiopulmonary bypass?

Answer 6

Blood drained from RA and returned to ascending aorta.
Systemic anticoagulant necessary
Induced hypothermia

Max time 12 hours
Max cardiac ischaemia time 6 hours

Question 7

Pros and cons of different prosthetic heart valves?

Answer 7

Biological: no warfarin needed but repeat op in 15 years

Mechanical: warfarin needed for life, valve lasts much longer

If possible repair is preferable