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cardiopulmonary test 4 > CV surgery > Flashcards

CV surgery Flashcards

1
Q

How many rib pairs are there in the dog and cat?

A

13

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2
Q

What needs to be avoided during surgical approach of the heart?

A

neurovascular bundle caudal to each adjacent rib

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3
Q

What are the different thoracic surgical approaches?

A
  • lateral thoracotomy (intercostal most common)
  • median sternotomy
  • transsternal
  • thoracoscopy (minimally invasive)
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4
Q

Most conditions require which approach to the heart?

A

left approach

PDA, persistent right aortic arch, pulmonic valve) (between ribs 4 and 5

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5
Q

What is a patent ductus arteriosus (PDA)?

A
  • failure of closure of normal embryonic ductus arteriosus after birth
  • blood shunts from high to low pressure system
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6
Q

What are the hemodynamic effects of PDA?

A
  • blood recirculated to right heart/lungs and back to left ventricle
  • over-circulation of lungs
  • LV hypertrophy
  • RA dilation can lead to atrial fibrillation
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7
Q

What are the clinical signs of PDA?

A
  • exercise intolerance
  • dyspnea
  • stunted growth
  • machinery murmur
  • hyperkinetic pulse
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8
Q

What is the objective of surgery for PDA?

A

occlusion of patent ductus

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9
Q

What are some preoperative considerations for PDA surgery?

A
  • detect right to left shunting
  • evaluate for concurrent congenital abnormalities
  • treat for preexisting sequelae
  • administer fluids with caution
  • pain management
  • anesthesia
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10
Q

When should surgery be performed for PDA?

A
  • sooner diagnosis if patient is asymptomatic

- if symptomatic, treat accordingly prior to anesthesia

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11
Q

How is surgery performed for PDA?

A
  • left fourth intercostal thoracotomy
  • PDA located between aorta and pulmonary artery
  • dissect around PDA and ligate with silk suture
  • be sure to dissect dorsally to ventrally on right side of aorta
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12
Q

What kind of suture is used to ligate a PDA?

A

circumferential suture (pulled up against the medial aspect of PDA from behind aorta)

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13
Q

What is the prognosis for PDA?

A

excellent if performed at early stage

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14
Q

What are some complications of PDA surgery?

A
  • hemorrhage

- recanalization

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15
Q

What are vascular ring anomalies?

A
  • congenital malformation of the aortic arch system
  • results in entrapment and constriction of esophagus
  • most common is persistent right aortic arch (PRAA)
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16
Q

What are the clinical signs of PRAA?

A
  • persistent regurgitation
  • aspiration pneumonia
  • thin, emaciated animal

(all signs associated with megaesophagus)

17
Q

What is seen in radiographs of PRAA?

A
  • esophageal dilation
  • ventral tracheal displacement
  • wide mediastinum
  • aspiration pneumonia
18
Q

What is the goal of PRAA surgery?

A

relieve esophageal constriction by transecting the ligamentum arteriosum

19
Q

What is the surgical approach for PRAA?

A

left fourth intercostal thoracotomy

20
Q

How is surgery performed for PRAA?

A
  • ligamentum arteriosum located between aorta and pulmonary trunk
  • dissected free
  • transected
21
Q

What is an important complication of PRAA surgery?

A

persistent megaesophagus

22
Q

What is involved with postoperative care following PRAA surgery?

A
  • elevated feedings
  • small, frequent meals
  • monitor for aspiration pneumonia
  • gradually begin feeding normally after 2 weeks
23
Q

What is pericardial effusion?

A

fluid within pericardial sac causes cardiac tamponade

24
Q

How do you diagnose pericardial effusion?

A
  • clinical signs associated with tamponade
  • electrical alternanes on ECG
  • globoid cardiac silhouette
  • pericardiocentesis
25
Q

What is thoracoscopic pericardectomy?

A
  • minimally invasive technique for palliative pericardial window
  • transdiaphragmatic approach
26
Q

What is pulmonic stenosis?

A
  • congenital stenosis of the pulmonary outflow tract

- valvular most common

27
Q

What are the hemodynamic effects of pulmonic stenosis?

A
  • increased RV pressure leading to hypertrophy
  • post-stenotic dilation of pulmonary artery
  • tricuspid insufficiency can occur
  • right heart failure
28
Q

What are the clinical signs of pulmonic stenosis?

A
  • exercise intolerance
  • dyspnea
  • syncope
  • systolic crescendo-decrescendo murmur
29
Q

How do you diagnose pulmonic stenosis?

A
  • elevated RV pressures

- RV enlargement with pulmonary artery dilation

30
Q

What are the indications for treatment of pulmonic stenosis?

A
  • dog <1yr old

- pressure gradient between the RV and pulmonary artery greater than 50mmHg

31
Q

What is the goal of pulmonic stenosis surgery?

A

increase diameter of outflow tract

32
Q

What is a valvulotomy?

A

stretching, tearing, or excision of stenotic valve and subvalvular fibrous ring

33
Q

What is involved in postoperative management of pulmonic stenosis?

A
  • thoracic drainage
  • pain management
  • activity restrictions

cardiopulmonary test 4 (11 decks)

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