cardiac surgery

Question 1

define mechanical valve

Answer 1

v durable, risk of thromboembolism is high, pts need lifelong anticoag

Question 2

define xenograft valve

Answer 2

made from porcine valves/pericardium

less durable

needs replacement at 8-10 yrs

advantage- dont need anticoag

Question 4

define homograph valve

Answer 4

cadaveric valves

useful in young pts + in replacement of infected valves

Question 5

complications of prosthetic valves

Answer 5

systemic embolism

infective endocardiis

hemolysis

structural valve failure

arrhythmias

Question 6

CABG- who is it performed in

Answer 6

L main stem disease

multivessel disease

multiple severe stenosis

pt unsuitable for angioplasty

failed angioplasty

refractory angina

Question 7

procedure

Answer 7

heart = stopped

blood pumped artificially by machine outside o’ body [cardiac bypass]

pts own saphenous vein/internal mammary artery = used as graft

several grafts may be placed

>50% of vein grafts close in 10 yrs [low dose aspirin helps prevent this]

int mammary a graft lasts longer but may cause chest numbness

Question 8

after CABG

Answer 8

if angina persists/recurs- restart antianginal drugs

consider angioplasty

ensure optimal mx of htn, dm, high xol, smoking

continue aspirin indefinitely [or clopi if aspirin CI]

exercise- walk, cycle, swim jog in that order..

drive @ 1 month

return to work @ 3 mo

Question 9

heart transplant

Answer 9

do if severely liiting cardiac disease

survival= not expected beyond 6-12 mo

Question 10

aortic root surgery

Answer 10

replacement/repair if dissection/aneurysmal