Ischeami herat disaes and valvular heart disease - cardiac surgurgy Flashcards
what can be dangerous with coronary artery diseease
left main stem stenois or 3 vessel coronary artery disase
what are indicators for coronary artery bypass grafting
symptoic with any coraory artery diseas patern
progoistic if have lmss or 3 vessels disease
what is requried for cabg
adequate lung ctuio
mental fuciton
hepatic fucin
asending aorta ok
distal coarory targes ok
lf ef greater tahn 20%
what veins can be used for cbg
reversed saphenous vein
intergna mamary artery
radial artereis
why is the saphenous vein reversed
as it has valves in it and if they run in the wrong direction there will be back flow of blood
what is a sternotomy
where there is an incision along the midline , it is then reattached through the use of wires
what are some probles with an sternocy
painful wires, wire infections, sternal dehiscenc, sternal malunion
what are the priamry features of cardiac tamponade
raised cvp, raised heart sounds, low np
what are the secondary feautes of cardiac surgury
oliguria, increaed oxygen requiremetns, metabolic acidosis
what is the treatet for cardiac tamponade
chest reopening
what are teh long term post cabg outcomes
50% have no further cardiac problm
of the remainder most only need minor medictoi
5% need repeat cabg
what valves are mainly effected in adutls an children often requiring surgy
adults - mitral and aortic
children - all 4 valves
what are the cause of valuar heart disease in adutls
degenerative
congential
infective
inflamatory
lv or rv dilatation
trauma
neoplastic
paraneoplatic
what are the 3 msot common types of valve problems requiring cardiac surgy
sensile tricupid aortic valve stenosi
bicupid aortic valve
degenerative mitral reguartion
what is acture rhuaji fever trated with
aspiri and bed est and penicllin
most common bacteria in endocarditis
strep viridans
second most common type of bacteria in endocarditis
staph aureus
what is the percent chabge of curing endocaris with antibiotic for a prostheic valve and a natural valve
prophic valve 50% chance , normla vale 90%
which endocaridits bacteria is easiest to treat
strep viridans
what is incation for surguery in endocarditis
severe vavluar regurgitation, sevre vegetations, persitant pyrexia, progressive renal faileru
how long should antibioc be given after endocarites
6 weeks
what does aortic stenos or atoic reguartion often prestn as
heart falruew, syncopa epois, or angian
is there a corrolation betwen the strenough of murmur in ar and the severtiy
yes
when is ar more severs
if there is lv dilation
