Valvular Heart Surgery Flashcards
Causes of Cardiac Ischaemia?
- Atherosclerosis
- Embolism
- Coronary thrombosis
- Aortic dissection
- Arteritides
- Cogenital
What is aortic dissection?
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).
What is arteritides?
Inflammation of artery
What would be the common manifestations of IHD?
- Angina
- MI
- Arrythmias
- Chronic Heart failure
- Sudden death
What are the two main serious patterns of coronary artery disease?
- Left main stenosis
- 3 vessel coronary artery disease
What are the incentives for CABG?
- Symptomatic
- Prognostic (LMSS, 3VDx)
How are patients selected for CABG?
Adequate -lung function -mental function -hepatic function Ascending aorta OK Distal coronary targets OK LVEF> 20%
What are the conduits used for CABG?
-Reversed saphenous vein
-Internal mammary
arteries
Radial arteries
What are the problems associated with sternotomy?
- Wire infection
- Painful wires
- Sternal dehiscence
- Sternal malunion
What is sternal dehiscence ?
Wires have cut through sternum
What are the post op problems in cardiac surgery?
- Cardiac Tamponade
- Death
- Stroke
What is Cardiac Tamponade?
Filling of pericardial sac with blood
What are the primary feature of cardiac tamponade?
Raised Central venous pressure
Raised heart rate,
Low BP
What are the secondary features?
-Oliguria (low out put of urine)
Increased oxgygen requirements
metabolic acidosis
How do you treat cardiac tamponade?
Chest re-opening
What percentage of post op pateints have no further cardiac problems after 10 yrs?
50%
What precentage of post op patients have minor problems which are easily controlled with medication?
50%
5% of patients may require what?
A repeat CABG
What are the two main valvular surgery in adults?
Aortic and MItral
What are the causes of valvular heart disease in the adult?
- Degenerative
- Congenital
- Infective
- Inflammatory
- LV or RV dilatation
- Trauma
- Neoplastic
- Paraneoplastic
What are the two types of endocarditis?
Acute
Sub acute
What causes sub acute endocarditis?
-Streptococcus`s veridans
Where is step veridans found most often as a comensal?
Teeth
What causes acute endocarditis?
Staph aureus
