Ischaemic HD - Surgery Flashcards

1
Q

What are the major dangerous patterns of coronary artery disease?

A

IF the Left Coronary Artery is stenosed
Or if all 3 vessels have coronary artery disease.

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2
Q

What 2 reasons are there for choosing surgery over ACS medical therapy?

A

Symptomatic reasoning, if the patient is very unwell and needs rapid intervention.
Prognostic intervention, if the patient has Left main stem stenosis or 3 vessel disease.

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3
Q

What are the 2 types of surgical intervention?

A

Angioplasty + Stenting
or CABG

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4
Q

What criteria are there for a CABG patient?

A
  • Adequate Lung Function
  • Adequate Mental Function
  • Adequate Hepatic Function
  • Ok ascending Aorta
  • Ok distal coroanry targets
  • LV Ejection Fraction > 20%
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5
Q

What conduits can we use for CABG?

A

Reversed Saphenous Vein, Internal mamary arteries, radial arteries or synthetic

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6
Q

What procedure gives access to the heart for CABG?

A

A sternotomy. Cutting through the centre of the sternum down the torso and then putting it back together with wires in the sternum.

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7
Q

What problems can occur due to the sternotomy?

A

The wires can be painful or infected.
Sternal Dehiscence - The sternal wound ruptures and comes apart
Stenal malunion - The sternum heals in an awkward position, possibly with wires stickin out

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8
Q

What problems can arise post-op in cardiac surgery?

A

Death
Stroke
Cardiac Tamponade (fluid accumulates in pericardial sac crushing the heart)

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9
Q

What are the symptoms of cardiac tamponade?

A

Raised HR & low BP
Dyspnoea
dizziness/syncope
Weakness

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10
Q

How do we treat cardiac tamponade?

A

Re-opening the chest and draining the fluid

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