Cardiac Surgical Procedures Flashcards
how is a Percutaneous Transluminal Coronary Angioplasty (PTCA) performed?
- catheter is threaded up to the are of the lesion or plaque
- the balloon is inflated to compress the lesion against arterial wall
- balloon can be inflated & deflated several times, as needed, to full compress the lesion
what is a PTCA used for?
moderate atherosclerosis in 1-2 arteries
how is a stent placement performed?
- A PTCA is performed
- the stent is around the tip of the PTCA catheter
- once the lesion is compressed, the stent is put in place to maintain luminal diameter
what is a PCI?
an angioplasty and stent was performed
what are the precautions following PTCA and/or Stent?
- if performed in femoral bed rest for the patient
- if performed in radial not many restriction
- once activity is initiated follow vitals & EKG closely and watch for signs of intolerance to activity
how is a Coronary Artery Bypass Graft (CABG) performed?
graft artery is harvested and then attached above & below the area of atherosclerosis
what does a CABG allow?
allows free blood through to the areas of the heart through the coronary arteries
what is a CABG used with?
moderate or severe CAD in one or more vessels
where can the grafts used for CABG come from?
- LIMA (left internal mammillary artery)
- Saphenous vein
- Radial artery
- occasionally RIMA (right internal mammillary artery)
for best long-term results where should the graft be harvested from for a CABG?
LIMA when possible for best long-term results secondary to resistance to graft stenosis
what are the precautions following CABG the day after surgery?
bedrest
what are the precautions on Day 1 after surgery and each day after following a CABG?
- follow any UE restrictions imposed by the surgeon
- follow any activity restrictions due to lines or monitoring equipment
- follow vitals & EKG closely
- watch for signs of intolerance to activity
why may a patient undergo an electrophysiologic ablation?
patient with an arrhythmia may undergo EP study to see if a specific spot of the heart is initiating the arrhythmia
what is done if one spot is found when performing an electrophysiologic ablation?
- do an ablation to cauterize tissue and the hope is to stop electrical current getting through which stops arrhythmia
- without active tissue at that spot the arrhythmia should be eliminated
what is an atrial or ventricular septal defect repair?
- correction of or closing a defect between the atriums, ventricles, or both
- defect is usually congenital, but may be from tumor
what valve is usually replaced?
- usually the aortic or mitral valve
- can be tricuspid or pulmonary valves
a valve replacement may be due to what?
insufficiency or stenosis
what may be used for a valve replacement?
artificial valve (metal) or a natural valve (from a pig)
what are the precautions following septum repair or valve replacement?
- bedrest the of surgery
- day 1 after surgery and each day after:
- follow any UE restrictions imposed by the surgeon
- follow any activity restrictions due to lines or monitoring equipment
- follow vitals & EKG closely
- watch for signs of intolerance to activity
when is a heart transplant given to patients?
given to patients with progressive, terminal, cardiovascular disease
what are the 2 types of heart transplants?
- orthotropic transplant (more common)
- heterotypic transplant
how is an orthotopic transplant performed?
- original heart is removed and the donor heart replaced it
- part of the original heart’s bilateral atria are left
- the donor heart is grafted right atrium to right atrium and left atrium to left atrium
how is a heterotypic transplant performed?
- original heart is left in place and the transplanted heart is placed on the opposite side of the chest and attached to the original
- it is attached to atria and ventricle to ventricle
what are the precautions following transplant?
- bedrest the day of surgery
- check with your specific facility for further precautions
what are the precautions following a transplant once activity is initiated?
- follow any UE restrictions imposed by the surgeon
- follow any activity restrictions due to lines or monitoring equipment
- follow any restrictions regarding exposure to other patients
- follow vitals & EKG closely
- watch for signs of intolerance to activity
