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EP4133: Exe for Clinical Populations > Test 2 lecture 5 > Flashcards

Test 2 lecture 5 Flashcards

1
Q

Goals of Revascularization (2)

A

-restore myocardial blood flow -improve prognosis (mortality and morbidity)

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2
Q

What is CABS?

A

Coronary Artery Bypass Surgery

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3
Q

What is PCI?

A

Percutaneous Coronary Intervention

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4
Q

What is PTCA?

A

Percutaneous Transluminal Coronary Angioplasty

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5
Q

In 2008, how many CABS cases were there?

A

240,000

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6
Q

In 2008, how many PCI cases were there?

A

817,000

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7
Q

Name the factors considered for revascularization (5)

A

-significant lesions (or more than 50% stenosis) -lesion location -plaque stability -prognosis -quality of life

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8
Q

How is the CABS procedure done?

A

It uses a graft to bypass the area of occlusion

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9
Q

What vein is normally used for the CABS procedure?

A

Saphenous vein

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10
Q

Name the indications for CABS (4)

A

-re-stenosis after PCI -multivessel disease -difficult lesions -disease not amenable (receptive) to PCI

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11
Q

Advanced CABS eliminated what two procedures?

A

-sternoctomy -heart-lung bypass

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12
Q

T/F: Surgeons for CABS can now operate on beating hearts.

A

True

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13
Q

Name the types of patients that should have CABS (4)

A

-post PCI with re-stenosis -multivessel disease not receptive to PCI -difficult lesions (bifurcated or distal) -other cases (PCI)

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14
Q

Name the things that can increase as a result of CABS (6)

A

-survival rate -functional capacity -left ventricular function -HR max -RPP -quality of life

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15
Q

Name the things that can decrease as a result of CABS (3)

A

-angina -ischemia -ST segment depression

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16
Q

CABS outcomes can depend on what three things?

A

-severity and location of lesion -age -co-morbidities

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17
Q

What are the re-occlusion rates for 1 year, 5 years and 11 years?

A

What are the re-occlusion rates for 1 year, 5 years and 11 years?

1 year: 10%,

5 Years: 20%

11 Years:40%

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18
Q

What is the purpose of the PTCA procedure?

A

Widens narrowed or obstructed vessels

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19
Q

Name the three techniques for PTCA

A

-balloon dilation -rotational atherectomy -directional atherectomy with laser

20
Q

Out of the three PTCA techniques, which is the most common?

A

Balloon dilation

21
Q

Which PTCA technique is used for central bulky lesions?

A

Rotational atherectomy

22
Q

Which PTCA technique is used for larger lesions but also has high risk for vessel damage?

A

Directional atherectomy with laser

23
Q

T/F: During PTCA procedures, the patient is often awake

A

True

24
Q

PCTA can improve what two things? What can it relieve?

A

It can improve functional capacity and quality of life. It can also relieve angina.

25
Q

T/F: Re-stenosis is not common after a PTCA procedure.

A

False, it occurs within in 6 months in 25% of patients

26
Q

Name the complications of PTCA (7)

A

-acute vessel closure -chronic re-stenosis -thrombotic distal embolism -myocardial infarction -arrhythmia -coronary artery dissection -bleeding

27
Q

What is stent therapy?

A

It is a procedure where a tube is inserted to keep an artery open

28
Q

What are the two types of stents used?

A

-bare metal stents -drug-eluting stents

29
Q

Stent therapy is often used in conjunction with what procedure?

A

PTCA procedure

30
Q

T/F: Drug-eluting stents can reduce acute complications and restenosis

A

True

31
Q

What does the drug-eluting stent prevent from happening?

A

It prevents the growth of scar tissue in the artery lining

32
Q

What does stent therapy relieve? What does it improve?

A

It relieves angina. It also improves functional capacity and quality of life.

33
Q

What’s the likelihood of restenosis for bare metal stents? For drug-eluting stents?

A

25-40% for bare metal, less than 10% for drug-eluting stents.

34
Q

What is the average hospital stay recommended for post CABS patients before a GXT is done?

A

2-5 days

35
Q

What is the average hospital stay recommended for post PTCA/stent patients before a GXT is done?

A

1-2 days

36
Q

What are the components on inpatient cardiac rehab? (3)

A

-ambulation -roll exercises -education

37
Q

T/F: Outpatients should not start cardiac rehab right away

A

False, they should start as early as possible

38
Q

T/F: Exercise can result in less restenosis following a PCI

A

True

39
Q

What is the reduction (percentage) in mortality risk as a result of exercise?

A

8-17%

40
Q

T/F: CABS patients usually experience faster progression when training

A

False, it is usually slower

41
Q

Initial CV training should have lower ____ and _____ before it is gradually increased (2)

A

-duration -intensity

42
Q

T/F: Initial CV training is not based on clinical status

A

False, it’s not based on GXT

43
Q

T/F: Later CV training is based on GXT

A

True

44
Q

T/F: Strength training is based on clinical status

A

True

45
Q

How long should CABS patients wait before starting strength training?

A

About 4 weeks or once the wound is stable

46
Q

What type of weights can be used for strength training?

A

Ankle or wrist

47
Q

T/F: PCI patients should wait just as long as CABS patients before starting a strength training program

A

False, they should start immediately

EP4133: Exe for Clinical Populations (10 decks)

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