cardiothoracic surgery Flashcards
CABG
coronary artery bypass grafts
graft vessel=saphenous vein or intermammary (thoracic) artery, radial artery
complications CABG
death
stroke
infection
AKI
cognitive impairment
MI
AF
most common indication for valve replacement
aortic stenosis
types of valve replacement
biprosthetic: lifespan 10y, porcine=pig
mechanical: lifespain 20y
INR range mechanical valve
2.5 to 3.5
complications mechanical valve
thrombus
IE
haemolysis->anaemia
what is TAVI used for
aortic stenosis
TAVI
catheter and biprosthetic valve through femoral artery -> aortic valve
ix for congenital heart defects
echo
cyanotic heart disease
R->L shunt
eisenmenger syndrome
original L->R shunt, pulmonary pressure increases, R->L shunt
complications congenital heart disease
HF
arrhthymia
endocarditis
stroke
pulmonary HTN
eisenmengers
ASD sx
mid systolic crescendo decrescendo murmur L sternal edge
fixed split S2
SOB
stroke: DVT travels to brain through hole
AF
VSD causes
congenital - downs syndrome, turners
after MI
sx VSD
pan systolic murmur L sternal edge
causes pansystolic murmur
VSD
mitral regurg
tricuspid regurg
coaractation aorta
narrowing of aortic arch - usually around ductus arterioisis
in turners syndrome
sx coaractation aorta
HTN
systolic murmur under L clavicle
lowe BP in legs and L arm
L ventricular heave
transudative causes pericardial effusion
increased venous pressure: congestive HF, pulmonary HTN
exudative causes pericardial effusion
inflammation: infectio, AI (SLE), uraemia, cancer, methorexate
types of causes pericardal effusion
transudative
exudative
cardiac tamponade: MI, trauma, aortic dissection
sx pericardial effusion
chest pain,
sob
orthopnea
phrenic nerve compression: hiccups
compression oesophagus: dysphagea
compression recurrent laryngeal nerve: hoarse voice
O/E: quiet HS, pulsus paradoxus, low BP, increased JVP
mx pericardial effusion
tx cause
drain: needle pericardiocentesis, surgery
false aneurysm
inner 2 layers (intima and media) rupture and vessel dilates
often after trauma
RF thoracic aortic aneurysm
M
marfans
smoking
sx thoracic aortic aneurusm
none
compression=pain, sob, hiccups, dysphagia, hoarse voice
mx thoracic aortic aneurysm
observe
TEVAR
sx ruptured thoracic aprtic aneurysm
bleeding
chest/back pain
haemodynamic instability
collapse
death
indications for heart transplant
congestive HF secondary to IHD
cardiomyopathy
congenital heart disease
complications heart transplant
cardiac autograft vasculopathy (narrowing coronary arteries of donor heart)
complications lung transplant
primary graft dysfunction
bronchiolitis obliterans syndrome
dehiscence of bronchial anastomosis
