CV final review Flashcards
What are the types of aortic AAA?
Crawford is most common- 1,2,3,4
1- descending aorta passing the diaphragm
2- plus or minus ascending aorta, with above and below diaphragm
3- above and below the diaphragm
4- below diaphragm only
Which Crawford system of thoracoabdominal aortic aneurysms are at highest risk for paraplegia/ renal failure/ renal artery/ radicular arteries involvement?
2- ascending aorta, as well ass above and below diaphragm
What crawford aneurysms are most difficult to repair?
2 and 3 because thoracic and abdominal aorta
Aortic dissection classifications
Standord- A (involves ascending aorta) & B (does not involve ascending aorta)
DeBakey- 1 (entire aorta), 2 (ascending aorta), 3 (descending aorta)
Stanford A= 1,2
Stanford B= 3
Which aortic dissection is a surgical emergency?
Stanford A/ DeBakey 1/2
What are independent risk factors for AAA
Male
Cigarette
Old age
S&S AAA rupture
Back pain
HOTN
Pulsatile abdominal mass
What is the most common cause of postop death after AAA rupture?
MI
When is AAA repair indicaited?
5.5 cm
or
0.6-0.8 growth/ year
Tell me about EVAR
Minimally invasive approach of correcting an AAA
Shorter operation, length of stay, lower morbidity
Regional has better outcomes
No cross clamp
Will receive contrast dye
Maintain UO
What is and how can an endoleak be treated?
Occurs when the graft fails to prevent blood from entering the aortic sac
Can resolve spontaneously, or might need a second graft, or open repair
S&S if occlusion of the artery of Adamkiewics during repair/ aortic cross clamp
Anterior spinal artery syndrome AKA Becks syndrome
-Bowel/ bladder dysfunction
-Flaccid paralysis of lower extremities
-Loss of temperature and pain sensation
Cross clamp time should be ___
<30 minutes
Spinal cord protection strategies to prevent ischemia
Moderate hypothermia 30 C
CSF drainage
Proximal HTN map 100
Avoid hyperglycemia
SSEP MEP
Partial CPB
Steroids, CCB, mannitol
When stenosis exceeds ___, CEA is indicated
70%
