lecture 6: cardiothoracic surgery Flashcards by sophia carrasco

what are the 4 percutaneous revascularization procedures that are done

percutaneous transluminal coronary
angioplasty
arthrectomy
stenting

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percutaneous revascularization procedures is designed to revascularizate the ___

myocardium

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what is a Balloon tip catheter inserted through femoral artery radial artery called

angioplasty

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during an angioplasty the ballon is inflated to push ___ against ___-

plaque against lumen

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after you get an angioplasty a ___ is placed afterwards

stent

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if someone got an angioplasty there is no vigorous exercise for 5-7 days (T/F)

True

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someone who received an angioplasty can develop ____ arrthymias

ventricular

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after someone gets an angioplasty the return of blood flow is checked via

angiogram

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immediately after someone get an angioplasty a ___ lb sandbag is placed over the ____ artery puncture site in the left and remains there for ___ hours , the purpose of this is to heal the artery heal and help stop the ___

10
femoral
6
bleeding

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what is Used for coronary artery stenosis due to larger plaque build up

arthrectomy

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do arthrectomy and angioplasty have a similar procedure ?

yes

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during an arthrectomy they insert a catheter with a ___ and ____ at the distal end

ballon and cutter

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if someone is needing to place an artery or vein into a blockage in the heart what are they going to get done

coronary artery bypass graft

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what are the 3 choices for graft for CABG

internal mammary arteries
radial arteries
saphenous veins

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after someone gets an CABG there is a __ to___ % chance the pateint will experience a heart attack

2-4

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myocardial stunning may happen after angioplasty which produces a ___ CO but can be reversible by iontropic meds , intraaortic ballon pump or LVAD

low

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what are some complications that patient may experience after a CABG

bleeding
neuro complication
infection

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what occurs up to 90% of patients are CABG

pleural effusions

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patients who get CABG can also experience ___ failure and ____ effusion

renal
pericardial

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median sternotomy is a ___ incision along the sternum and requires ___ closure for healing

verticle
wire

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eternal precaution for a median sternotomy include movement and lifting limitation for ___ to ___ weeks

6-8

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what Device is used to temporarily restore cardiac output for people with Severe heart failure, post-op cardiac surgery, cardiogenic shock

intraortic ballon pump

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intraaortic ballon pump is typically inserted thru the ___ artery or ___ artery

femoral or axillary

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IABP is Typically inserted through the ____ artery or ____ artery

femoral or axillary

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the intraaortic ballon pump will inflate during ___ and deflate during ___

diastole systole

the whole purpose for the IABP is to maximize ___

if someone has a femoral artery placement for IABP then the patient is on strict ___

bed rest

if someone uses axillary or iliac artery from IABP then ___ might be allowed

ambulation

which valve is the most commonly replaced

aortic valve (most pressure)

when someone uses the pulmonary valve to replace the aortic valve and the Pulmonary valve is replaced with donor valve what procedure is this called

ross

can the aortic valve be repaired ?

no just replaces

which valves are rarely needed for repair or replacement

tricuspid and pulmonic ( bc low pressure)

what type of procedure will be done with a valve replacement?

open heart sx (median sternotomy)

if someone has a mechanical valve replacement then the patient is required to be on life long ___ ___ to prevent thrombus formation

blood thinners

the bioprosthesis replacement has a reduced risk for ____

stroke

mechanical valve replacements have an ___ risk for stroke

increase

are patients required to be on lifelong blood thinners iof they have a broprosthesis replacement?

TAVR , TMVR, TPVR and robot assisted valve repair are examples of what

percutaneous

what produce is A flexible ring place around the mitral valve to support the reconstruction and to reinforce the annulus

mitral repair with annuloplasty

is it better to get a valve replacement or repair

repair

mitral repair has a better ___ of over mitral replacement

durability

a big thing that is different between valve repair over valve replacement is that is does ___ require long term anticoagulation therapy to prevent thromboembolic events for mechanical valves

not

which procedures are Designed to destroy ectopic cells located within the myocardium responsible for initiating the arrhythmias

cardiac ablation

Cardiac Ablation Procedures produces a scar at the ___ to kill the ectopic cells

myocardium

what procedure is a standard surgical procedure for the treatment of atrial fibrillation with or without heart disease (acquired or congenital).

cryomaze

CRYOMAZE uses a _____ technology to create the "cuts" in the heart to block the abnormal circular electrical waves, instead of actual cuts with a blade.

freezing

if you indicate SA node disorders (bradyarrhythmias) , AV nodeal disorders (heart block ), or tachyarrhythmias (SVTs) what will be implanted

pacemaker

with helps with A systole

pacemaker

what are the 2 types of pacemakers

unipolar and bipolar

the unipolar pace marker has ___ electrode and there is one at the ______ (-) and second within the pace marker box

one myocardium

the bipolar pace markers has ___ leads , one at the right ___ , two at the ____

3 atrium ventricles

implantable cardioverter defibrillator is used to prevent life threatening ____

arrhythmias

Implantable Cardioverter Defibrillator (ICD) is used to correct what type of arrthymias

bradyarrthymias (pacemaker fxn) tachyarrhythmias

a pace marker or ICD can be placed ____ inside the right atrium and ventricle via access through a large vein (subclavian, int jugular, cephalic)

endocardially

a pacemaker or IDC can be places ___ and It is used more often in children and patients undergoing heart surgery at the same time and often used for temporary pacing

epicardially

incision for a pacemaker/ ICD is where

pec minor and upper pec major

after someone has a pacemaker implanted there is no shoulder ___ , > then ____ degress for 4 weeks

elevation 90

post op considerations after a pacemaker is implanted is no shoulder ___ or horizontal ___ pass the plane of the trunk

extension abd

after someone has a pacemarker implanted there is no ___ anything over 10 lbs for 4 weeks

lifting

there will be a spike in the ___ wave which means atrial or a spike in the ____ complex which means ventricles , for someone with a pacemaker

p qrs

a carotid endarectomy is to reestablish ____ supply

blood

the surgical incision for the carotid endarectomy is along the anterior border of the ___

SCM

what is Indicated for aneurysms > 5cm or wit rapid enlargement and Sudden change in characteristic of pain

Abdominal Aortic Aneurysm Repair

the incision for the Abdominal Aortic Aneurysm Repair is at the midline of the ___ and proceeds to the ____

xiphoid pubis

post op considerations for someone who has an Abdominal Aortic Aneurysm Repair is to purposely discourage the use of of ___ mm during coughing

abs

what is the Procedure used to drain excess fluid from pleural space

thoracocentesis

someone who is having a thoractomy will have a large incision made thru the ____ mm

intercostals

during a posterolateral thoracotomy this is an incision from ____ to 6th IC space

what muscle is divided during posterolaterla thoracotomy

serratus anterior

which never is preserved during a posterolateral thoracotomy

long thoracic nerve

someone who had an anterolaterla thoracotomy will have an incision form the ___ and ___ IC space at the mid axillary line to the midclavicular region

4th and 5th

which muscle is incised and which muslce fibers are separated for someone who has a anterolaterla thoracotomy

pec major SA

someone that had a lateral thoracotomy will have an incision near the ___ line and extending towards the scap

nipple line

which muscle is retracted during a laterla thoracotomy and which mm are incised

lats SA and intercostals

someone who had a Thoracoabdominal Incision will have an incision at the e___ and ____ IC space at the post axillary line to midline of abdomen

8th and 9th

what are some post op difficulties with someone with a Thoracoabdominal Incision

coughing deep breathing thoracic extension