heart trnasplant

Question 1

what is the site specific criteria for heart transplant

Answer 1

1.age: 30- must lose weight before listind due to increased risk for infection, dvt/pe, poor wound healing
4.poor renal function
diabetes’s with end organ damage/ poor controlled diabetes (hbga1c->7.5 (norm 4-6, 7 good for DM)
5. symtomac cerbrovacular disease
6. PVD that limits exercise

Question 2

what are the relative contraindications of heart transplant

Answer 2

active smoking
drug/ alcohol abuse
mental retardation/ dementia
hx of poor medication compliance
elevated PA pressure

Question 3

describe recipient criteria

Answer 3

1A
1B
II

Question 4

histocompatibility complex (HLA)

Answer 4

used to determine the amount of immunosupression post op

Question 5

what are the external components of a VAD

Answer 5

diveline
controller
powersource

Question 6

what do you avoid for an internal VAD

Answer 6

trunk flexion- to can cut off the cannula

Question 7

what is “ suckdown”

Answer 7

when the there isn’t enough volume, the LV can collapse

VAD does not adequately fill
loss of CO
CAUSED: orthostatic hypotension
TREATMENT: supine, LE elveatedd, tell VAD team

Question 8

what are the issues go the VAD

Answer 8

thrombosis
infection
dysarrthmia

Question 9

what are the signs of heart transplant rejection

Answer 9

fatigue, decreases ex tolerance, systemic swelling, JVD, abnormal lung sounds, abnormal heart sounds, fever

Question 10

what are the three compensations to improve cardiac output for a person with HF

Answer 10

1. DECREASED CO WITH ACTIVITY
   
   • diminished EF systole
     - architectural changes in LV
2. HEIGHTENED SYMPATHETIC ACTIVATION
   
   • elevated resting HR, decreased HRR
3. ANDOTENSIN- ALDESTRONE SYSTE ACTIVATION
   - increase vasoconstriction, increase plasma volume , increased or decreased BP