Cardiac Surgery Flashcards
1
Q
Coronary Artery Bypass Leading contributor
A
Atherosclerosis
2
Q
Pre-op Care for Coronary Artery Bypass
A
- Initial Workup (Cath, labs, echo, 12 lead EKG, PFTs, T&C, CXR, Labs)
- Night before Sx (shower, BPO after midnight, pre-op teaching, consents, psychological support, sleeping aid)
- Morning of Sx (pre-op meds, IV starts, Psychological support)
3
Q
CABG procedure
A
- open thoracotomy (coronary bypass, saphenous vein)
- use of heart-lung machine (cannulate inferior/superior vena cava and aorta, oxygenates blood)
- MIDCAB procedure
4
Q
Complications of CABG
A
- low CO
- Acute MI
- Dysrrhythmias
- Hemorrhage
- Pulmonary embolus
- Electrolye Imbalance (K, Mg, Ca)
- Cerebral infarction
- ARDS
- Renal Failure
- Cardiac tamponade
5
Q
Cardiac Output
A
amount of blood ejected from the heart in one minute
4-8 L/min
6
Q
Stroke Volume
A
amount of blood ejected from the ventricle with each contraction
(60-130 mL/beat)
7
Q
Drugs Effecting CO
A
- Dopamine
- Dobutamine
8
Q
Dopamine Low Dose
A
increases renal artery perfusion
1-5 mcg/kg/min
9
Q
Dopamine Moderate Dose
A
BETA
increases CO by increased HR and contractility
(5-10 mcg/kg/min)
10
Q
Dopamine High Dose
A
Alpha
vasocontriction, elevated BP
Over 10 mcg/kg/min
11
Q
Dobutamine
A
increases contractility, therefore CO without increasing HR
- 2 to 20 mcg/kg/min
- titrated to patient response
12
Q
Valve Replacement: Biological
A
- human
- procine
- bovine
13
Q
Valve Replacement: Mechanical
A
- Ball-n-cage
- leaflet
14
Q
Intra-Aortic Balloon Pump (IABP)
A
- counter-pulsation device
- assist to refill the coronary arteries
- inflates when the ventricles are resting
- placed via femoral artery
15
Q
Indications for IABP
A
- LV failure
- Mechanical dysfunction 2 AMI
- Uncontrolled Ventricular Arrhythmias
- Unstable Angina
- Septic/Cardiogenic Shock
- Prophylactically
