Exam #2: Cardiac Surgery Flashcards
Valvular Heart Disease includes
- Mitral Stenosis
- Mitral Insufficiency (Regurgitation and Prolapse)
- Aortic Stenosis
- Aortic Insufficiency (Regurgitation and Prolapse)
Procedures for Valvular Heart Disease include
- Valvular repair/reconstruction (nothing to repair insufficient valves therefore they may need valve replacement)
- Valvular replacement:
- mechanical valve (do not want in young females because they would have to be on long term anticoagulant therapy)
- biological valves
Percutaneous Transluminal Balloon Valvuloplasty
- Procedure for a stenotic, calcific aortic valve.
- Look at pictures on PowerPoint
Biological Heart Valves
- Most common
- Slow heart rate down
- Sutured in place = risk for clotting. Therefore, they may need low molecular weight heparin for 6-12 weeeks
Aortic Aneurysms
- Outpouching or dilation of the arterial wall.
- May involve the aortic arch, thoracic aorta and/or the abdominal aorta. (Most found in abdominal aorta)
True Aneurysm
Thinning of arterial wall that causes an outpouching
True Aneurysm: Fusiform
..
False Aneurysm
Protrusion (which is actually a clot) d/t torn part of artery wall
Look up better definition
Clinical Manifestations of Throracic Aneurysms
- Thoracic aneurysms are often asymptomatic with the first sign being rupture
- Symptoms may include pain in the back, neck, and substernal area that may only occur when lying supine
- The client may experience dysphagia and dyspnea, stridor, or cough when pressing on the esophagus or laryngeal nerve
Clinical Manifestations of Abdominal Aneurysms
- Abdominal aneurysms may also be asymptomatic until ruputre
- The client may report a “heartbeat” in the abdomen when lying down
- A pulsating abdominal mass may be present
- Moderate to severe abdominal or lumbar pain may be present (severe pain may be a sign of impending rupture).
- The client may experience claudication
- Cool or cyanotic extremities may be noted
- Systolic bruit may be heard
Dissecting Aneurysms: Clinical Manifestations
- Present with sudden, severe, and persistent pain described as “tearing” or “ripping” in the anterior chest or the back
- Pain may extend to the shoulder, epigastric area, or abdomen
- Pallor, sweating, and tachycardia will be evidence
- Initially the client may have an elevated BP that may be different in one arm from the other
- Possible syncope and paralysis of lower extremities may be present
Complications of Aortic Aneurysm: If rupture occurs posteriorly into the retroperitoneal space,
- Bleeding may be tamponaded by surrounding structures, preventing exsanguination and death.
- Patient often has severe back pain and may or may not have back or flank ecchymosis
Complications of Aortic Aneurysms: If rupture occurs anteriorly into the abdominal cavity,
Death from massive hemorrhage
Aortic Aneurysm: Diagnostic Studies include
- Chest x-ray
- Ultrasound
- CT scan
- MRI
- ECG
- Angiography
Aortic Aneurysm: Overall Goals
- NO RUPTURE
- Normal tissue perfusion
- Intact motor and neurologic function
- No complications of surgical repair
