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10 Cards in this Set
- Front
- Back
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1. Prior to bypass, which vessel is cannulated first, aorta or right atrium?
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a. Aorta-RA cannulation is associated with hemodynamic problems and therefore the Arotic cannula may be used for immediate tx regimens
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2. With cannulation of the aorta and/or the initiation of bypass it is determined that one of the aortic arch vessels was cannulated. List 3 signs/symptoms or possible methods of making this diagnosis.
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a. Asymetrical facial blanching (color changes),
b. edema, petechiea or dilated pupils, c. difference in pulse pressures, d. difference in BP in both arms, e. asymmetric cooling of neck, f. carotid asymmetric thrill during cannulation g. MAP of 30 torr or less |
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3. List 2 signs/symptoms that aortic dissection has/is occurred with aortic cannulation and the initiation of bypass.
(Incidence is only 0.02-0.35%) with |
a. Sudden drop in VR and arterial BP
b. Loss of volume (perfusate) c. Perfusionist detects an in arterial line pressure d. Blue discoloration of aortic root with bleeding |
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4. List 2 steps in the management of aortic dissection, which has been precipitated by aortic cannulation, and the initiation of bypass.
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a. Promptly discontinue CPB
b. Reposition or Recannulation distal to dissection c. Induce deep hypothermic arrest with repair of the dissection |
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5. List 1 possible complication associated with Venous Cannulation for bypass.
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a. VC obstruction-SVC worse than IVC
b. artial arrythmias c. atrial/caval laceration d. air embolization e. malposition of catheter(s) f. HOTN |
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6. List 1 possible cause for low venous return from a patient to the bypass machine.
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a. misplace catheter
b. obstruction-consider venous air lock c. hypovolemia d. inadequate pump volume e. vasodilation (due to drugs, temp changes, hemodilution) |
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7. List the 3 mechanisms, which are employed on bypass to reduce the oxygen requirements of the heart. (3pt)
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a. Hypothermia )10% of decrease in O2 requirements)
b. Electromechanical arrest (KCl – 50% of the decrease in O2 requirements) c. Decompression (venting – 40% reduction of O2 requirements) |
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8. List 3 advantages of venting for cardiopulmonary bypass. (3pt)
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a. Minimize LV distention
b. Dry surgical field/Sx Exposure c. Decrease in MVO2 d. Subendocardial blood flow enhanced e. Rewarming of cold preserved heart is decreased f. Prevent cardiac ejection of air g. Distribution of cardioplegia improved h. Increased return to CPB |
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9. Infusion of cardioplegia is accomplished under what pressures? (1pt)
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Antegrade – 80-100mmHg
Retrograde-40-50 mmHg although Dr. Taylor stated 30-50 – OK |
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10. What percentage of venous return to the cardiopulmonary bypass machine is received from the:
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SVC 1/3 blood flow
IVC 2/3 blood flow |
