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Perf Tech Exam One > EXAM ONE > Flashcards

EXAM ONE Flashcards

1
Q

NY Heart Association Functional Classification

A

Functional Class I-IV

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2
Q

Functional Class II

A

Slight limitation of physical activity. Ordinary activity results in fatigue, palpitations, dyspnea, or angina pain

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3
Q

Functional III

A

Marked limitation of physical activity. Less than ordinary activity causes fatigue, palpitations, dyspnea or angina pain.

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4
Q

Functional Class IV

A

Inability to carry out any physical activity without discomfort, symptoms maybe present at rest

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5
Q

Functional Class I

A

No Limitation of Physical Activity (people dont even know that they have any problems

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6
Q

CAD?

A

Coronary Artery Disease

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7
Q

CAD (coronary artery disease) results from…..?

A

From Progressive blockage by atherothrombotic disease

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8
Q

Myocardial Revascularization

A

Taking LIMA or LITA and using it as a graft

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9
Q

Myocardial revascularization: Coronary Artery bypass grafts (CABG) Patency Rates???

A

Saphenous Vein Graft: 10-15% occlusion within one month (thrombotic occlusion) and 10 year follow up is 50% occlusion

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10
Q

Internal Mammary Graft Patency rate?

A

10 year follow up with only 10% occlusion

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11
Q

10-15% occlusion (patency rate) within one month is for what type of occlusion?

A

A saphenous vein graft and its a thrombotic occlusion

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12
Q

Off-pump revascularization ?

A

OPCAB: Off-pump coronary artery bypass

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13
Q

Percutaneous coronary intervention

A

PCI-is a non-surgical procedure that uses a catheter to place a small structure called a stent to open yo the vessels in the heart that have been narrowed by plaque buildup (atherosclerosis)

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14
Q

Other interventions for coronary artery disease: Percutaneous

A
  • PTCA: Percutaneous transluminal coronary angioplasty
  • Transluminal stent {bare metal vs. drug-eluding}
  • Percutaneous atherectomy
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15
Q

PTCA?

A

Percutaneous Transluminal Coronary Angioplasty: minimally invasive procedure to open up blocked coronary arteries which allows blood to circulate unobstructed to the heart muscle.

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16
Q

Other Interventions for CAD

A

MIDCAB: minimally invasive direct coronary artery bypass
TECAB: robotic/totally endoscopic coronary artery bypass
TMR: Transmyocardial revascularization

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17
Q

MIDCAB???

A

Minimally invasive direct coronary artery bypass

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18
Q

TECAB

A

Robotic/totally endoscopic coronary artery bypass

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19
Q

TMR

A

Transmyocardial revascularization

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20
Q

Complications Ischemic Heart Disease

A

Left Ventricular aneurysm
Post-infarction ventricular septal rupture
Ischemic mitral regurgitation

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21
Q

Left Ventricual Aneurysm

A

Coronary occlusion may produce extensive transmutation necrosis

Converses muscle into thin scar tissue

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22
Q

Left Ventricular Aneurysm (linear closure)

A

Teflon felt is used to close up the ventricle

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23
Q

Left Ventricular Aneurysm (patch)

A

Purse-string sutures is used

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24
Q

Ventricular Septal Rupture

A

Usually occurs within 1st week of infarct
Symptoms: pulmonary edema, and cardiogenic shock
Emergency surgery indicated for nearly all (surgical mortality is 30%)

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25
Q

Heart Valves

A

Stenosis: the opening of the valve becomes smaller thus allowing less blood to flow through

Regurgitation/insufficiency (leaky valve): the valve does not close properly and allows blood to flow backward as well as forward in the heart.

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26
Q

Stenosis

A

The opening of the valve becomes smaller, thus allowing less blood to flow through

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27
Q

Regurgitation/insufficiency (leaky valve)

A

The valve does not close properly and it allows blood to flow backwards as well as forwards in the heart

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28
Q

Heart Valve Surgery

A

Aortic valve replacement
Mitral valve replacement/repair
Tricuspid valve replacement/repair
Surgery for endocarditis

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29
Q

Aortic valve replacement

A

Mechanical vs. Tissue

Scented vs. Stentless {xenografts-autografts-homografts}

30
Q

Ross Procedure

A

Cut out the bad aortic valve and cut out the pulmonary autograft than replace aortic with pulmonary and place cryopreserved pulmonary homograft at the pulmonary

31
Q

Bentall Procedure

A

Clamp the aortic anuresym ends then cut open and replace

32
Q

Other methods of Aortic valve Replacements

A

Transfemoral/transaortic and transapical

33
Q

Percutaneous Aortic valve

A

Transfemoral or transapical

34
Q

3 types of TAVR

A

Transfemoral
Transapical
Transaortic (TA0)

35
Q

Open Heart Surgery

A

AVR (Aortic Valve Replacement)

36
Q

Minimal Incision Valve Surgery (MIVS)

A

Can be used for an Aortic valve replacement

37
Q

Mitral Valve Replacement or repair (leaflets, chords, annulus) 3 types…

A

Annuloplasty
Valvuloplasty
Commissurotomy

38
Q

Know the tricuspid valve repair

A

Repair when blood is leaking back into r. Atrium (regurgitation)

39
Q

Heart Valve Surgery

A

Surgery for endocarditis: excision of infected tissue/repair or replace valve

40
Q

Intravenous Drug Use (image)

A

Pulmonic regurgitation, tricuspid regurgitation, septic emboli, pneumonia, high incidence of tricuspid bacterial endocarditis with IV drug use

41
Q

Aortic Surgery

A
  • Dissection

- Aneurysm

42
Q

Dissection 2types

A

Type A all over the head

Type B defending aorta

43
Q

Aneurysm (4 types)

A
  • aortic root Aneurysm
  • ascending aortic aneurysm
  • aortic arch aneurysm
  • descending aortic aneurysm
44
Q

Aortic Surgery

A
  • aortic root surgery (valve/conduit combination)
  • aortic arch surgery (cerebral protection)
  • throacoabdominal (spinal cord protection)
  • Bypass vs. percutaneous
45
Q

Crawford classification of Thoracoabdominal aneurysms

A

I
II
III
IV

46
Q

Percutaneous aortic surgery

A

TEVAR:Thoracic Endovascular Aortic repair

47
Q

Miscellaneous

  • Atrial Fibrillation
  • Pericardial Disease
  • Cardiac tumors
A

Atrial Fibrillation:
You use Maze III procedure; cryoablation, radiofrequency, and high-freq. ultrasound
Pericardial Disease: Pericardial restriction/tampnade
Cardiac tumors: primary vs. secondary benign vs. malignant

48
Q

Atrial Fibrillation

A

Maze III procedure (cox-maze iii)
Cryoalbation
Radiofrequency and high freq. ultrasound

49
Q

Pericardial Disease

A

Pericardial restriction/tamponade

…. specimens taken via incision in the 5th left intercostal space

50
Q

Cardiac tumors (TWO types)

A

Primary and Secondary

Benign and Malignant

51
Q

Primary Cardiac Tumors

A

Benign: 75% of cardiac tumors
Respond well to surgical resection

Malignant: 25% of cardiac tumors
Almost all incurable

52
Q

2types of cardiac tumors that are BENIGN

A

Myxoma

Lipoma, fibroelastoma and rhabdomyoma

53
Q

Myxoma

A 
Benign cardiac tumor: 41% of benign primary tumors in adults
15% in children
More common in women
Age range of 30 to 60
75% originates in the left atrium
54
Q

Lipoma, fibroelastoma, rhabdomyoma

A

59% of benign primary tumors

Equal occurrence

55
Q

Malignant cardiac tumor

A

Almost all sarcomas (considers transplants)

Angiosarcoma and rhabdomyosarcoma

56
Q

2 types of cardiac malignant tumors that are Sarcoma….

A

Angiosarcoma

Rhabdomyosarcoma

57
Q

Angiosarcoma

A

More common in men
Most arise from the right atrium or pericardium
Very vascular

58
Q

Rhabdomyosarcoma

A

Arise all areas of the heart

Slight male predominance

59
Q

Cardiac Tumors Secondary

A

Metastatic
30x more common than primary
10-12% of patients with widely metastatic tumors have cardiac involvement
Surgery palliative-mainly for recurrent pericardial effusions

60
Q

Surgery for Trauma (4types)

A

Blunt aortic trauma
Blunt cardiac trauma
Penetrating mediastinal trauma
Penetration cardiac trauma

61
Q

Blunt aortic trauma (surgery)

A

80% to 90% die at the scene

50% of remaining die within 48hours if not properly treated

62
Q

Blunt Cardiac trauma

A

Involved in up to 20% of all MVA deaths (motor vehicle accidents)

63
Q

Surgery for trauma: penetrating mediastinal trauma

A

Rare that major structures avoided

64
Q

Penetrating cardiac trauma

A

Fatality rates of 70-80%

Patients who survive usually do so because of pericardial tamponade

65
Q

Transplants

A

Heart
Lungs
Heart-Lung

66
Q

Congenital Defects (14 total)

A 
ASD
Vent. Septal defect
Atrioventricular septal defect
Patient ductus arteriosus
Tricuspid atresia
Pulmonary atresia with intact ventricular septum
Tetralogy of fallot
Hypoplastic left heart
Transposition of the great arteries
Double outlet right ventricle
Truncus arteriosus
Interrupted aortic arch
Coarctation of the aorta
Total anomalous pulmonary venous connection
67
Q

Total CPB Time (minutes)
ASD/VSD
CABGx1/CABGx2
CABGx3

A

20to 60 mins (ASD/VSD)
30-60
90-180

68
Q

Total CPB Time (mins)

Single Valve
Multiple Procedures
Tumor Removal

A

60-120
120-180
30-90 *estimated times based on average clinical experiences

69
Q

CPB Time(minutes)
Trauma
Root Replacement w/valve
Aortic Repair

A

Trauma 60-120
>= 120 (root replacement w/valve)
>=240-300 (aortic repair)

70
Q

CPB time
Thoracoabdominal repair

Congenital defect repair

A

> = 300 hours

Varies greatly on kid

71
Q

Top 10 causes of death 2015

A
  1. Ischemic heart attack
  2. Stroke
  3. Lower respira.
  4. Chronic obstructive
  5. Trachea
  6. Diabetes
  7. Alzheimer disease
  8. Diarrheal disease
    9 TB
    10 road injury

Perf Tech Exam One (1 decks)

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