Test 2 lecture 5

Question 1

Goals of Revascularization (2)

Answer 1

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

Question 2

What is CABS?

Answer 2

Coronary Artery Bypass Surgery

Question 3

What is PCI?

Answer 3

Percutaneous Coronary Intervention

Question 4

What is PTCA?

Answer 4

Percutaneous Transluminal Coronary Angioplasty

Question 5

In 2008, how many CABS cases were there?

Answer 5

240,000

Question 6

In 2008, how many PCI cases were there?

Answer 6

817,000

Question 7

Name the factors considered for revascularization (5)

Answer 7

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

Question 8

How is the CABS procedure done?

Answer 8

It uses a graft to bypass the area of occlusion

Question 9

What vein is normally used for the CABS procedure?

Answer 9

Saphenous vein

Question 10

Name the indications for CABS (4)

Answer 10

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

Question 11

Advanced CABS eliminated what two procedures?

Answer 11

-sternoctomy -heart-lung bypass

Question 12

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

Answer 12

True

Question 13

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

Answer 13

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

Question 14

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

Answer 14

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

Question 15

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

Answer 15

-angina -ischemia -ST segment depression

Question 16

CABS outcomes can depend on what three things?

Answer 16

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

Question 17

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

Answer 17

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

1 year: 10%,

5 Years: 20%

11 Years:40%

Question 18

What is the purpose of the PTCA procedure?

Answer 18

Widens narrowed or obstructed vessels

Question 19

Name the three techniques for PTCA

Answer 19

-balloon dilation -rotational atherectomy -directional atherectomy with laser

Question 20

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

Answer 20

Balloon dilation

Question 21

Which PTCA technique is used for central bulky lesions?

Answer 21

Rotational atherectomy

Question 22

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

Answer 22

Directional atherectomy with laser

Question 23

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

Answer 23

True

Question 24

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

Answer 24

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

Question 25

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

Answer 25

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

Question 26

Name the complications of PTCA (7)

Answer 26

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

Question 27

What is stent therapy?

Answer 27

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

Question 28

What are the two types of stents used?

Answer 28

-bare metal stents -drug-eluting stents

Question 29

Stent therapy is often used in conjunction with what procedure?

Answer 29

PTCA procedure

Question 30

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

Answer 30

True

Question 31

What does the drug-eluting stent prevent from happening?

Answer 31

It prevents the growth of scar tissue in the artery lining

Question 32

What does stent therapy relieve? What does it improve?

Answer 32

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

Question 33

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

Answer 33

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

Question 34

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

Answer 34

2-5 days

Question 35

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

Answer 35

1-2 days

Question 36

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

Answer 36

-ambulation -roll exercises -education

Question 37

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

Answer 37

False, they should start as early as possible

Question 38

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

Answer 38

True

Question 39

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

Answer 39

8-17%

Question 40

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

Answer 40

False, it is usually slower

Question 41

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

Answer 41

-duration -intensity

Question 42

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

Answer 42

False, it's not based on GXT

Question 43

T/F: Later CV training is based on GXT

Answer 43

True

Question 44

T/F: Strength training is based on clinical status

Answer 44

True

Question 45

How long should CABS patients wait before starting strength training?

Answer 45

About 4 weeks or once the wound is stable

Question 46

What type of weights can be used for strength training?

Answer 46

Ankle or wrist

Question 47

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

Answer 47

False, they should start immediately