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Cardiac Pathologies > CARDIOVASCULAR PROCEDURES AND INTERVENTION SURGERIES > Flashcards

CARDIOVASCULAR PROCEDURES AND INTERVENTION SURGERIES Flashcards

1
Q

True or false: percutaneous & endoscopic CV procedures are considered “ closed” approach

A

true

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2
Q

during a cardiac catheterization, contrast dye injected and x-ray are taken as the contrast material moves through the chambers, valves, and vessels
THIS PART IS CALLED __________________

A

ANGIOGRAM

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3
Q

Percutaneous Transluminal Coronary Angioplasty (Aka: Percutaneous Coronary Intervention) uses a _______ to keep the fatty plaque compressed against the artery walls and the diameter of the blood vessel is widened (dilated) to increase blood flow to the heart

A

Ballon angioplasty

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4
Q

Potential complications of Percutaneous Transluminal Coronary Angioplasty

A
  • Vessel recoil
  • Restenosis
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5
Q

Percutaneous Transluminal Rotational or Directional Atherectomy is

A

Plaque Removal using a special catheter that grinds away the plaque on arterial walls

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6
Q

Potential complications of atherectomy procedure

A
  • Unclear effectiveness in coronary arteries
  • Restenosis, acute complications
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7
Q
A
  • Stents – Bare-Metal: in-stent restenosis; anti-clotting meds
  • Drug Eluting Stents: markedly reduces the rate of re narrowing; use of anti-platelet therapy
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8
Q

Intracoronary radiation therapy by the insertion of radioactive implants directly into the tissue.

A

Brachytherapy

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9
Q

💡Brachytherapy

Radiation therapy aimed at restenosis has two purposes:

A
  1. Treat restenosis itself
  2. Prevent further restenosis
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10
Q

A surgery performed on a beating heart in select patients with severe Aortic Stenosis or Pulmonary Valve Congenital Defects who are not candidates for traditional open chest or are high risk.

A

Transcatheter Aortic Valve Replacement

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11
Q

when can aerobic and resistance training begin after Percutaneous & Endoscopic procedures?

A

almost immediately

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12
Q

Generally, uncomplicated Percutaneous Coronary Intervention patients are discharged from hospital after ______ Percutaneous & Endoscopic

A

24 hrs

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13
Q

Most frequently used incision for open heart surgery:

A

Sternotomy

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14
Q

CABG, Valve Repair/Replacement, Aneurysm repair, Ventricular Assist Devices and Transplants are surgeries done via ______

A

Sternotomy

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15
Q

Sternal Precautions

A
  • Avoid lifting heavy objects
  • Avoid bilateral overhead activities or unilateral ROM if pain. HOWEVER, ROM definitely OK and recommended to
  • Avoid pushing or pulling heavy objects
  • Avoid sports
  • Avoid driving
  • Avoid repetitive or sustained arm movements
  • Sternal Click/Sternal Instability avoid adhesions
  • Splinted Cough
  • Incentive Spirometer
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16
Q

Coronary Artery Bypass Graft uses which arteries?

A
  • Internal Mammary Artery: most commonly used; best long-term results
  • Saphenous Vein: minimally invasive nowadays
  • Radial Artery
  • Gastroepiploic Artery to stomach & Inferior Epigastric Artery to abdominal wall less commonly used
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17
Q

Performs work of the heart & lungs while they are stopped during “On-Pump” surgery to allow work on a “still” heart

A

Heart-Lung Machine

(As opposed to “Off-Pump” surgery where heart remains beating)

18
Q

After CABG Surgery mobilization starts as early as

A

24-48hrs POST

Aerobic training - within 20-25 bpm of RHR (NYP); 30 bpm (ACSM)

19
Q

Valve replacement types

A
  • Human – homograft/allograft: lifespan ~10 yrs, now extending
  • Animal – porcine, bovine: lifespan ~10 yrs, now extending
  • Mechanical: durable but lifelong anticoagulants
20
Q
  • Commissurotomy
  • Decalcification
  • Triangular resection
  • Annulus Support
  • Patched Leaflets
A

Valve Repair surgeries

21
Q

💡PT considerations

Activity after valve surgery

A
  • Generally same guidelines as post-CABG
  • However, these patients MAY have had greater activity restrictions and/or longer periods with symptoms prior to surgery
    • This lower functional capacity MAY require valve surgery patients to start at a lower level and progress more slowly
22
Q

a device that helps left ventricle pump blood to the aorta

A

LVAD: Left Ventricular Assist Device

23
Q

Left Ventricular Assist Device, indications:

A
  • Severe hemodynamic compromise despite medication & other interventions
  • Bridge to transplant
  • Until heart able to pump effectively or during surgery, OR Long term treatment
24
Q

Left Ventricular Assist Device, PT considerations

A
  • Sternal Precautions Apply
  • Pts usually severely deconditioned & weak with prolonged hospitalizations
  • Need Borg scale to monitor level of exertion (NYP 11, others 13-14)
  • Watch out for the driveline, sutured in, pt’s may wear an abdominal binder, can’t get wet.
  • Batteries last 10 hours
  • Pts get “dry” and need to drink water, especially prior to exercise, to maintain CO
25
Q

Heart transplant, Orthotopic Approach:

A

The more common of the two procedures, the orthotopic approach, requires replacing the recipient heart with the donor heart

26
Q

Heart transplant, heterotopic approach.

A

Heterotopic transplantation, also called “piggyback” transplantation, is accomplished by leaving the recipient’s heart in place and connecting the donor heart to the right side of the chest.

27
Q

Heart Transplant, PT Considerations

A
  • Massive anti-rejection drugs given; biggest risk is rejection
  • Exercise Intolerance
  • Loss of muscle mass and strength
  • Decreased or diminished autonomic cardiac innervation
  • Side effects of immunosuppressive medication:
    • Dyslipidemia, HTN, obesity, diabetes
28
Q

Heart transplant delayed response to exercise:

A
  • In response to sub-maximal exercise CO increase is achieved by increase in SV, not H
  • At higher work rates, myocardium responds with tachycardia
  • Post-exercise HR remains elevated for longer period because of lack of parasympathetic innervation
29
Q

Cardiac Transplant PT Considerations during exercise:

A
  • Use RPE or dyspnea as guidelines
  • Longer periods of warm-up and cool-down
  • Progressive aerobic exercise
  • Long term resistive exercise
  • Monitor BP, side effects of meds, signs of exercise intolerance (may signal rejection)
30
Q

Thoracotomy, approach used for:

A

– Lung surgery
– Aneurysm repair

31
Q

Video Assisted Thoracoscopy

A

– “minimally invasive”
– Used for “smaller” lung surgeries
– Similar concept as done with joints
– Faster recovery time

32
Q

Thoracoabdominal Approach

A
  • Very large incision
  • Increased pain w/ movement & coughing
  • Get the patients moving fast!
33
Q

PT considerations post thoracotomy and thoracoabdominal approaches

A
  • FUNCTIONAL MOBILITY
  • Shoulder and Trunk ROM (to avoid adhesions)
  • Deep Breathing Exercises
  • Incentive Spirometry
  • Splinted Cough
34
Q
A

Endarterectomy
surgical removal of part of the inner lining of an artery, together with any obstructive deposits, most often carried out on the carotid artery or on vessels supplying the legs.

35
Q

Creates an artificial action potential to maintain a suitable HR or stimulate ventricles. May be used to treat syncope, CHF or hypertrophic cardiomyopathy

A

Pacemaker

36
Q

Automatic Implantable Cardioverter Defibrillator can have dual functions:

A
  • Pace
  • Defibrillate
37
Q

this type of pacemaker can detects Vtach and/or Vfib and delivers a “shock” in attemting to “reset” the conduction system

A

Automatic Implantable Cardioverter Defibrillator

38
Q

PT considerations in patients with pacemakers:

A
  • Use Borg Scale
  • Monitor systolic BP
  • Extended warm-up and cool-down
39
Q

PT considerations in patients with Implantable Cardioverter Defibrillator:

A
  • Closely monitor for safe exercise
  • Know limits and cutoff rates so patient doesn’t receive shocks at high HRs
40
Q

💡 ROM? ⏱?

PT considerations in patients p/o 1-2 days pacemaker implantation

A
  • Limited UE ROM immediately post implantation, pt may be in a sling for 1-2 days
  • Limited UE ROM above shoulder to 90 deg in first 2 weeks
41
Q
A

hypoglycemia

42
Q
A

hyperglycemia

Cardiac Pathologies (13 decks)

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