Quiz 4 Flashcards
usually for single vessel LIMA to LAD bypass
MID-CAB
CaO2 (oxygen content) =
1.31 x Hgb x SaO2 + 0.003PaO2
look at slide 11
.
OPCAB anesthetic management (6):
- GETA with or without Thoracic Epidural
- Monitors – Arterial Line, CVP, PAC, TEE, Cerebral Oximetry, 5Lead EKG, Standard ASA monitors
- Warming Device (forced air, blanket)
- IVF – Fluid warmers, Colloid vs Crystalloid, RBCs
- Drugs – Low dose Heparin, Antifibrinolytics, Narcotics
- CPB on Backup
Graft Harvesting : (4)
- LIMA
- RIMA
- LSVG
- LRad
look at slide 15
.
Risks of OPCABG Surgery (6):
- Direct trauma to myocardium
- Unprotected myocardium with occlusion of coronary targets
- Decreased cardiac function intra-op
- Decreased Cardiac Output / Organ perfusion / Systemic Pressure
- Increased requirement for drips intra-op
- Decreased graft patency due to technical difficulty or thrombosis
How much oxygen does the heart extract?
65 - 75 %
What is the benefit of doing a MIDCAB?
-Thoracotomy approach (NO incision through the sternum)
What vessels are involved in a MIDCAB?
LIMA to LAD
What contributes the most to cardiac O2 demand?
HR
Which has more O2 extraction the SVC or the IVC?
SVC
What are a few things that affect mixed venous oxygen?
- Anemia
- FiO2
- PEEP
- Temperature
- CO
What arteries branches off the Left Main Coronary Artery?
- Left Anterior Descending (LAD)
- Circumflex
The Circumflex perfuses the SA node in ___% of people
40
The right coronary artery perfuses the S.A. node in __% and the AV node in __%
60 %
80 - 90%
What is the percent of people that have a Posterior descending artery perfused by the RCA or referred to as the “________________”.
85 % , right dominate system
T/F: Adenosine (from ATP breakdown) is probably the MOST important metabolic blood flow regulator.
TRUE
What determines myocardial O2 demand?
- Heart Rate
- Contractility
- Wall Stress
What three things determine wall stress?
- Afterload
- Preload
- Wall Thickness
ST segment depression denotes ___________ ischemia.
endocardial
ST segment elevation denotes ________ ischemia.
transmural
