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Systems: Cardiovascular > Valvular Heart Surgery > Flashcards

Valvular Heart Surgery Flashcards

1
Q

Causes of Cardiac Ischaemia?

A
  • Atherosclerosis
  • Embolism
  • Coronary thrombosis
  • Aortic dissection
  • Arteritides
  • Cogenital
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2
Q

What is aortic dissection?

A

An aortic dissection is a serious condition in which the tunica intima layer of the aorta, the large blood vessel branching off the heart, tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate (dissect).

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3
Q

What is arteritides?

A

Inflammation of artery

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4
Q

What would be the common manifestations of IHD?

A
  • Angina
  • MI
  • Arrythmias
  • Chronic Heart failure
  • Sudden death
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5
Q

What are the two main serious patterns of coronary artery disease?

A
  • Left main stenosis

- 3 vessel coronary artery disease

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6
Q

What are the incentives for CABG?

A
  • Symptomatic

- Prognostic (LMSS, 3VDx)

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7
Q

How are patients selected for CABG?

A 
Adequate
-lung function
-mental function
-hepatic function
Ascending aorta OK
Distal coronary targets OK
LVEF> 20%
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8
Q

What are the conduits used for CABG?

A

-Reversed saphenous vein
-Internal mammary
arteries
Radial arteries

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9
Q

What are the problems associated with sternotomy?

A
  • Wire infection
  • Painful wires
  • Sternal dehiscence
  • Sternal malunion
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10
Q

What is sternal dehiscence ?

A

Wires have cut through sternum

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11
Q

What are the post op problems in cardiac surgery?

A
  • Cardiac Tamponade
  • Death
  • Stroke
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12
Q

What is Cardiac Tamponade?

A

Filling of pericardial sac with blood

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13
Q

What are the primary feature of cardiac tamponade?

A

Raised Central venous pressure
Raised heart rate,
Low BP

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14
Q

What are the secondary features?

A

-Oliguria (low out put of urine)
Increased oxgygen requirements
metabolic acidosis

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15
Q

How do you treat cardiac tamponade?

A

Chest re-opening

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16
Q

What percentage of post op pateints have no further cardiac problems after 10 yrs?

A

50%

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17
Q

What precentage of post op patients have minor problems which are easily controlled with medication?

A

50%

18
Q

5% of patients may require what?

A

A repeat CABG

19
Q

What are the two main valvular surgery in adults?

A

Aortic and MItral

20
Q

What are the causes of valvular heart disease in the adult?

A
  • Degenerative
  • Congenital
  • Infective
  • Inflammatory
  • LV or RV dilatation
  • Trauma
  • Neoplastic
  • Paraneoplastic
21
Q

What are the two types of endocarditis?

A

Acute

Sub acute

22
Q

What causes sub acute endocarditis?

A

-Streptococcus`s veridans

23
Q

Where is step veridans found most often as a comensal?

A

Teeth

24
Q

What causes acute endocarditis?

A

Staph aureus

25
Q

What demographic can acute endocarditis be seen often in?

A

Drug users

26
Q

What are the three commonest valve problems in cardiac surgery in Aberdeen?

A
  • Senile Tricuspid AS
  • Bicuspid AS
  • Degenerative MR
27
Q

What is Rheumatic fever related?

A

Streptococcal infections

28
Q

What is the hallmark pathology of Rheumatic fever?

A

Pancarditis

29
Q

What manifestations are usual for rheumatic fever?

A

Skin and joint

30
Q

What happens if rheumatic fever reaches the brain?

A

Sydenhams chorea (St. Vitus Dance (jerk mvmts)

31
Q

What is the most common heart problem world wide?

A

Rheumtatic fever

32
Q

What does NVE stand for?

A

Native valve endocarditis

33
Q

What does PVE stand for?

A

Prosthetic valve endocarditis

34
Q

Can you cure NVE with antibiotics?

A

90% chance of cure

35
Q

Can you PVE with antibiotics?

A

50% chance of cure with antibiotics (cannot travel through metal work)

36
Q

What are the indications for surgery in endocarditis?

A
  • Severe Valvular regurgitation
  • Large vegetations (cause Stroke)
  • Persistent pyrexia
  • Progressive renal failure
37
Q

After operation how in endocarditis treated?

A

Antibiotics given for 6 weeks

38
Q

What happens to biological valves when used to treat aortic stenosis?

A

Will need replacement after 10 years

39
Q

Why would you use biological valve replacements when they have to be replaced?

A

No need for Warfarin

40
Q

When is surgery recommended for MS?

A

If ECHO is <1.5cm2

41
Q

What is the max time limit for CPB?

A

Time limit 12 hrs

42
Q

How long will mechanical valve last?

A

> 40 years

Systems: Cardiovascular (31 decks)

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