Myocardial Revascularization

Question 1

What are 4 clinical procedures to restore myocardial blood flow?

Answer 1

1.) PTCS
2.) Stent Therapy
3.) CABG
4.) LVAD

Question 2

What is a PTCA procedure?

Answer 2

Percutaneous Transluminal Coronary Angioplasty (less invasive than CABG)

Question 3

What is a Stent Therapy?

Answer 3

Use of a mesh tube to treat narrowed or weakened arteries.

(can be used in conjunction with PTCA)

Question 4

What is a CABG procedure?

Answer 4

Coronary Artery Bypass Graft.

Question 5

What is a LVAD procedure?

Answer 5

Left Ventricular Assist Device.

Question 6

What are some success rate predictors of revascularization procedure?

Answer 6

Age, How acute is the syndrome, Other Existing Comorbidities (Diabetes & Antiocoagulant Therapy)

Question 7

Why do we use Anticoagulants?

Answer 7

So you don’t get a blood clot, thrombosis, and/or stroke.

Question 8

What are 3 types of Coronary Syndrome?

Answer 8

Unstable Angina, Stemi, NStemi

Question 9

What is an Unstable Angina?

Answer 9

Partial Rupture of an artery. (does not cause permanent damage to the heart)

Question 10

What is a STEMI?

Answer 10

“classic” heart attack (causes extensive heart damage)

Question 11

What is a NSTEMI?

Answer 11

Intermediate form of ACS (causes less extensive damage to the heart)

Question 12

Unstable Angina will showcase what on an ECG?

Answer 12

T Inversion

Question 13

NSTEMI will showcase what on an ECG?

Answer 13

ST Depression

Question 14

STEMI will showcase what on an ECG?

Answer 14

ST Elevation

Question 15

What ECG characteristics will be viewable on an abnormal ECG readout?

Answer 15

ST Elevation (Stemi), ST Depression (NStemi), T-Inversion (Unstable Angina)

Question 16

Retenosis typically occurs in ____ % of cases and within ____ months?

Answer 16

30% of cases & within 6 months

Question 17

CABG can improve the survival rate in patients with what types of heart disease?

Answer 17

Left Main CAD, Multi-Vessel Disease (2-3 vessels)

Question 18

What is the success rate with CABG?

Answer 18

90-95%

Question 19

What are the occlusion rate of grafts at 1 year, 5 year, and 11 years?

Answer 19

10% after 1 year
20% after 5 years
40% after 11 years

Question 20

What are some post-op education for CABG patients?

Answer 20

Wound care, managing recurring symptoms, risk factor modification.

Question 21

What is a PTCA procedure?

Answer 21

Percutaneous Transluminal Coronary Angioplasty

Question 22

What does a PTCA procedure entail?

Answer 22

Non-Surgical (less invasive than CABG) utilizing either Ballon Dilation or Stent Therapy

Question 23

What types of grafts are used for a Coronary Artery Bypass Graft (CABG)

Answer 23

Venous Graft (from an arm or leg) or an Arterial Graft (from internal mammary artery)

Question 24

Left Main Coronary Artery stenosis of how much is an indication for CABG?

Answer 24

50%

Question 25

Stenosis of Proximal LAD & Proximal Circumflex of how much is an indication for CABG?

Answer 25

> 70%

Question 26

Asymptomatic patients with what types of heart disease are indications for CABG?

Answer 26

3-Vessel Disease or Mild/Stable Angina

Question 27

What are some complications with CABG?

Answer 27

Respiratory, Cardiovascular, Wound, Joint Stiffness, Muscle Weakness, Postural Deformity.

Question 28

What are some respiratory complications associated with CABG?

Answer 28

Infection, Consolidation/Collapse, Pneumothorax, Haemothorax.

Question 29

What are some cardiovascular complications associated with CABG?

Answer 29

Deep Vein Thrombosis, Cardiac Arrest, Arrhythmias, Tamponade, Emboli.

Question 30

What are some wound complications associated with CABG?

Answer 30

Infection, Unhealed, Scar Tissue (multiple types).

Question 31

What are some joint stiffness complications associated with CABG?

Answer 31

Stiff: shoulder and girdle, thoracic spine, CV joints.

Question 32

What are some muscle weakness complications associated with CABG?

Answer 32

Incision Related, Leg and Abdominal (disuse / bed rest)

Question 33

What are some postural deformity complications associated with CABG?

Answer 33

Protraction, Scolosis.

Question 34

What is a LVAD (left ventricular assist device)?

Answer 34

A surgically implanted mechanical pump that is attached to the heart.

Question 35

How is a LVAD different from an artificial heart?

Answer 35

LVAD works with the heart to help it pump more blood with less work, whereas an artificial heart replaces the failing heart completely.