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Cardiology: Key Information > Cardiothoracic Surgery > Flashcards

Cardiothoracic Surgery Flashcards

1
Q

what is coronary artery bypass graft (CABG)?

A

uses a graft blood vessel taken from elsewhere in the body to bypass a blockage in the coronary atery

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2
Q

where is the graft blood vessel usually taken from?

A

saphenous vein

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3
Q

scar in CABG

A

midline sternotomy scar

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4
Q

what does the right coronary artery supply (RCA)?

A

RA
RV
inferior aspect of LV
posterior septal area

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5
Q

what does the circumflex artery supply?

A

LA

posterior aspect of LV

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6
Q

what does LAD supply?

A

anterior aspect of the LV and anterior aspect of the septum

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7
Q

what does atherosclerosis cause?

A

stiffening of artery walls leading to hypertension and strain on the heart (increased resistance)
stenosis leading to reduced blood flow (angina)
plaque rupture, thrombus and ischaemia

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8
Q

what can ED be an indicator of?

A

arterial disease

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9
Q

what is cardiopulmonary bypass?

A

takes blood from the vena cava/ RA and pumps it through a machine that adds oxygen and removes CO2 fro the blood and pumps it back into the ascending aorta

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10
Q

what medication is given alongside cardiopulmonary bypass?

A

heparin

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11
Q

what is cardioplegia?

A

stopping the heart from beating

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12
Q

how to cause cardioplegia?

A

delivering a high K+ solution to the coronary circulation

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13
Q

three main options for graft vessels

A 
saphenous vein (inner leg)
internal thoracic artery
radial artery
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14
Q

what is a pedicled graft?

A

artery is proximally attached to original site whilst changing where it supplies

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15
Q

what is a free graft?

A

separated from its original connections

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16
Q

why are vein grafts not as good as arteries?

A

become stenosed (intimal hyperplasia)

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17
Q

how long is recovery in grafts?

A

3 months uncomplicated

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18
Q

heart valve scar

A

midline sternotomy (mitral or aortic)

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19
Q

types of valve replacements

A
  1. bioprosthetic

2. metallic mechanical valve

20
Q

lifespan of bioprosthetic

A

10 years

21
Q

what is required in metallic mechanical valves?

A

lifelong anticoagulation

22
Q

INR target in metallic mechanical valves

A

2.5-3.5

23
Q

types of metallic mechanical valves

A
  1. Starr-Edwards
  2. Tilting disc
  3. St Jude valves/ bileaflet valves
24
Q

why are star-edwards no longer used?

A

high risk of thrombus formation

25
Q

which metallic mechanical valve type has the lowest risk of thrombus formation

A

st judes/ bileaflet valves

26
Q

major complications of mechanical heart valves

A

thrombus
IE
haemolysis/ anaemia

27
Q

when is a transcatheter aortic valve implantation TAVI used?

A

severe aortic stenosis

28
Q

procedure in a TAVI

A

catheter inserted into the femoral artery under XR

balloon inflated to stretch valve and implant a bioprosthetic valve

29
Q

two divisions of congenital heart disease

A
  1. cyanotic

2. acyanotic

30
Q

what is cyanotic heart disease

A

bypasses pulmonary circulation (right to left shunt)

31
Q

conditions that cause cyanotic heart disease

A

VSD
ASD
PDA
transposition of the great arteries

32
Q

eisenmengers syndrome

A

blood flows across defect despite higher pressure in left size of the heart

33
Q

types of ASD

A
  1. PFO (not strictly classified as ASD)
  2. ostium secondum
  3. ostium primum (tends to lead to AVSD)
34
Q

why does blood move from left to right?

A

higher pressure in the left side of the heart

35
Q

what does blood movement to the right side of the heart cause?

A

RVH

36
Q

DVT + stroke

A

ASD or VSD clot

37
Q

murmur in ASD

A

mid-systolic crescendo-decrescendo murmur at upper left sternal border with fixed split of S2 (pulmonary valve closing later due to blood flow increase)

38
Q

management of ASD

A

watch and wait
percutaneous catheter closure
open heart surgery
anticoagulation

39
Q

VSD condition associations

A

DOwn’s

Turner’s

40
Q

can VSD develop after MI?

A

yes

41
Q

murmur in VSD

A

pan-systolic at lower left sternal border (3rd-4th ICS)

systolic thrill

42
Q

pan-systolic murmur

A

VSD
mitral regurg
tricupsid regurg

43
Q

management of VSD

A

transvenous catheter closure
open heart surgery

risks IE

44
Q

VVI pacing

A

used in atrial conditions as atria are not sending proper contractions to ventricles

45
Q

fibrillation in the context of a normal HR

A

not particularly pathological

46
Q

AAI pacing

A

used for SA node dysfunction

47
Q

DDD mode pacing

A

both atria and ventricles

Cardiology: Key Information (42 decks)

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