Cardiac Surgery (2) Flashcards
What is Percutaneous coronary intervention?
Non surgical provide her that uses a catheter and balloon to place a stent to open a vessel
What are the two types of stents used in Percutaneous coronary intervention?
Bare metal stents
Drug eluting stents (more commonly used today)
What is an endarterectomy?
Surgical removal of part of the inner lining of the artery or any obstructive deposits
Where is an endarterectomy most commonly performed?
Carotid and femoral arteries
What is a temporary epicardial pacer?
Pacer to control heart rate and rhythm because myocardium is prone to arrhythmia post open heart surgery
What is the most common restriction when getting a pacemaker?
Limited L UE motion and exertion 1-2 weeks
What is the safety margin that patients should maintain when getting a pacemaker?
10% between exercise HR and rate cutoff for device
What are implantable cardioverter defibrillators useful for?
Preventing sudden death in patients with known ventricular tachycardia or fibrillation
What does an implantable cardioverter defibrillator do?
Tracks HR and rhythm and applies a shock to absolve any arrhythmias
What surgeries use a median sternotomy?
CABG
Valve replacement or repair
Heart transplant
What is a thoractomy used for?
Lobectomy
What is a bilateral thoracotomy (clamshell) used for?
Lung transplant
What is a minimally invasive cardiac surgery used for?
CABG
Valve surgery
What is a video assisted thoracic surgery used for?
Lobectomy (lung cancer)
What are the common vessels used for a CABG?
Saphenous vein
Left internal mammary artery
Why are left internal mammary arteries becoming more used than saphenous artery for CABG?
Remains open longer (90% in 10 years)
Saphenous still used for emergency CABG due to easier access
What are the disadvantages of using a left internal mammary artery for a CABG?
Limited length of vessel
May prolong surgery
Risk of Sternal wound failure
How long does a CABG surgery take to complete?
About 4 hours
How is the body supported during a CABG?
By a cardiopulmonary bypass for about 90 minutes
How often can someone get out of the ICU after a CABG?
The day after surgery
What are complications post CABG?
Temporary atrial fibrillation due to surgical trauma to heart (most resolves one month after surgery)
What type of valves are used for a valve replacement surgery?
Mechanical
Biological made of human (cadaver) or pig tissue (xenograft)
What’s the risk of getting a mechanical valve replacement?
Requires anti-coagulant meds for thrombus risk and has higher risk of infection
Who is a trans-catheter valve repair used in?
Patients at high risk for open heart surgery (older patients)
