Exam 3 ppt key points Flashcards
What are the Risk Factors for CAD
Age Gender (Male) Family Hx Smoking- 6x greater in women, 3x greater in males HTN High Cholesterol- high LDL & low HDL Diabetes Obesity Physical Inactivity Stress
At the center of the cardiovascular system is ?
the heart.
Myocardial blood supply is derived entirely from ?
the right and left coronary arteries.
The left coronary normally supplies
the LA, interventricular septum, and LV.
The right coronary normally supplies
the RA, most of the RV, and variable amounts of LV.
The most frequently performed cardiac operation is?
Coronary artery bypass grafting
CABG technique involves bypass of a narrowed or occluded epicardial coronary with a small-diameter conduit distal to the narrowed segment. Selected grafts include?
reversed saphenous
internal mammary artery
___________ appears to have superior long-term performance with 90% patency rates at 10 years.
The IMA
The choice of conduit in CABG depends on?
availability and durability
50% of vein grafts will be significantly diseased or occluded at 10 years.
The IMA appears to have superior long-term performance with 90% patency rates at 10 years.
When using a saphenous vein graft in CABG, the proximal arterial inflow source is?
the ascending aorta.
When the LIMA is utilized in CABG, the proximal arterial inflow source is
the left subclavian artery.
_________ is used to replace the function of the heart in CPB
Arterial pump
Arterial pump generally uses one of two primary technologies
A roller pump
A centrifugal pump – thought to be less traumatic
Identify the correct order of steps to CPB
- Priming
- Anticoagulation
- Cannulation
- Initiation
- Maintenance
- Weaning and Termination
The solution used to prime the CPB circuit is generally _______
a balanced electrolyte solution
Hemodilution in CPB is due to?
Prime volume
Standard procedure requires that the patient be ___________ before cannulation for CPB. _______ is still the standard agent used.
fully anticoagulated
Heparin
Heparin administered through a central venous catheter at an initial dose of ________ for CPB
300 U/kg
Heparin Onset is almost immediate, but generally the drug is allowed to circulate for ______________ before it’s effect is measured.
3-5 minutes
The ACT must increase to at least _______ before CPB is initiated.
300 seconds
400 for most institutions
The ACT is not used to monitor heparin levels but to monitor __________
the anticoagulant effects of heparin and other anticoagulants.
Elevated ACT measurements taken, before, during, or after CPB may be influenced by variables other than heparin which include?
Hypothermia
Hemodilution
Aprotinin
Every CPB procedure requires a high-flow cannula in a large vein and another in a large artery for withdrawing blood from and returning blood to the patient. The target for venous cannulation is ?
RA- It’s appendage is conveniently accessible through a sternotomy.
The RA may also be approached through the femoral vein.
For CPB venous cannulation, the right atrium can be accessed through?
appendage is conveniently accessible through a sternotomy.
The RA may also be approached through the femoral vein.