Topic 2 - Cardiac Surgery Overview Flashcards
1
Q
NY Heart Association Cardiac Functional Classification
A
I - No limitation
II - Slight limitation. Ordinary activity causes pain
III - Marked limitation. Less than ordinary activity causes pain
IV - Cannot perform physical activity
V - On VAD
2
Q
Types of Cardiac Interventions
A
- Myocardial revascularization
- Complications of ischemia heart disease
- Heart Valve Surgery
- Aortic surgery
- Neoplasms
- Trauma
- Transplants
- Congenital defects
3
Q
Myocardial revascularization
A
- Harvest greater saphenous vein (endoscopic is better)
- Can harvest radial artery (have to perform Allen test to check eligibility and make sure ulnar artery is sufficient)
- Usually graft to LITA aka LIMA (longest potency)
4
Q
CABG potency rates
A
- Saphenous: 10-15% occlusion in 1 month/50% in 10 years
- Internal mammory: 10% in 10 years
- Radial artery ~ IMA
5
Q
Pre-op evaluation for revascularization
A
- ETT (exercise tolerance test)
- Stress test (radionucleide)
- PET (positron emission tomography)
- MRI
- CT (Comnputerized axial tomography)
- Cardiac Catheterization
6
Q
ETT
A
- Exercise tolerance test
- Can bring out abnormalities in heart caused by blockages in coronary arteries that are unapparent at rest
7
Q
Dobutamine Stress test
A
- Used if treadmill is not an option
- Like EPI that focuses on heart
8
Q
Radionuclide Stress Test
A
- Insert radioactive isotope
- Take picture of heart pre and post exercise
- “Cold” areas don’t absorb the radionuclide which means poor perfusion at site
9
Q
PET
A
- Identifies perfusion poor tissues
- Less detail than CT or MRI
- Expensive
10
Q
MRI
A
- Strong magnet aligns protons in tissues
- Provides granular 3D image
11
Q
CT
A
- Multiple 2D images put together to make one 3D image
- Substantial source of radiation
12
Q
Cardiac Catheterization
A
- Gold standard for pre-op evaluation
- Tells us indications for procedure / description of procedure / hemodynamics data / coronary anatomy / ventricular function / valve regurgitation
13
Q
PTI
A
- Percutaneous Coronary Intervention
- What we can do after Cath is put in
- Balloon pump (just buys time)
- Stents
- Athrectomy (sucking root-rooter)
- Brachytherapy
- Aortic valve implantation
14
Q
Complications Ischemic Heart Disease
A
- Post MI
- Ventricular Septal Rupture
- Left ventricular aneurysm (can close linearly or w/ patch)
15
Q
Heart valve surgery
A
- Aortic valve replacement (mechanical vs tissue)
- Aortic valve repair
- Mitral valve replacement/repair
- Tricuspid valve replacement/repair
- Surgery for endocarditis
