Cardiac Surg Flashcards
(19 cards)
What is the focus of invasive cardiac procedures?
Treatment for coronary artery disease (CAD)
What are the two major procedures for CAD?
PTCA: Percutaneous Transluminal Coronary Angioplasty and Stent Implantation.
What are the indications for PCI?
Persistent chest discomfort despite medication, ischemia evident during stress testing, STEMI, and NSTEMI.
What is PTCA?
Involves balloon-tipped catheter opening blocked coronary arteries and compressing atheroma to restore blood flow.
What is the goal of the PTCA procedure?
<20% residual stenosis, increased arterial lumen, no obvious trauma.
What are coronary artery stents used for?
Used post-PTCA to prevent restenosis from inflammation, vasoconstriction, clotting, and scarring.
What are the types of coronary artery stents?
Bare-metal stents (no meds) and drug-eluting stents (release meds to prevent thrombus/scar).
What is the antiplatelet therapy duration for bare-metal and drug-eluting stents?
1 month post bare-metal and 1 year post drug-eluting.
What are some complications of PTCA?
Coronary dissection or perforation, abrupt vessel closure, vasospasm, acute MI, dysrhythmias/cardiac arrest, bleeding, hematoma, and acute kidney injury (AKI).
What is the post-procedure care for PTCA?
ICU if emergent, IV heparin or thrombin inhibitors, monitor aPTT, hematoma, and vitals.
What is coronary artery revascularization?
Done when medical/PCI fails, procedure: CABG (Coronary Artery Bypass Graft).
What are the indications for CABG?
Angina not controlled by meds or PCI, left main artery stenosis, multi-vessel disease, and other factors like 70% stenosis.
What is the most common cardiac surgery?
CABG, especially in older adults.
What is the preferred graft for traditional CABG?
Internal mammary artery.
What is required for traditional CABG?
Median sternotomy, chest tubes, epicardial pacer wires, and CPB.
What is off-pump CABG (OPCAB)?
No CPB but still uses sternotomy.
What is included in the CABG pre-op nursing process?
Full history, physical, pre-op tests, patient education, and prophylactic antibiotics.
What should be monitored during CABG intra-op care?
Complications and maintaining a sterile environment.
What are potential post-op complications of CABG?
Hemodynamic issues, organ dysfunction, hypertension, fluid overload, and electrolyte imbalances.
