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10 Cards in this Set
- Front
- Back
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Purpose?
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Myocardial revascularization w/ conduit to bypass occluded vessel
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Indications?
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Vessel disease
Diffuse atherosclerotic lesions LV dysfunction |
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Describe the vessels used for the CABG
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Saphenous vein
-req 2 anastomosis sites -endoscopic harvesting possible Internal mammary artery -left or right, LIMA or RIMA -best choice, better patency -only one anastomosis site Radial artery -associated with high rates of spasm |
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What is important to note about the mechanical circulation and oxygenation of blood during the procedure?
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It is heparinized and hemodiluted
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What is the purpose of a COX-MAZE procedure?
Describe the TMR procedure |
Tx for afib
Transmyocardial surgical laser revascularization Angina refractory to medical therapies |
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Describe 2 main points about a beating heart surgery
Describe cell saver |
It is done "off-pump" and it is less invasive
Intraoperative cell salvage machine suctions, washes, and filters blood so it can be given back tot he patient's body instead of being thrown away. |
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Describe function of mediastinal tube
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-mediastinal space encloses the esophagus, trachea, heart and aorta
-removes fluid from mediastinal space |
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Management for CABG Mediastinal Tubes
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Monitor mediastinal tube drainage
-too much > 100 mL/hr x2 call MD ADM PLATELETS, FFB, PRBC PROTAMINE -too little; if fresh postop expect more output --assess for cardiac tamponade otherwise maybe ok |
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Describe Cardiac tamponade manifestations
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Elevated filling pressures (cvp, padp, paop)
Dec CO Dec BP JVD Muffled heart tones Sudden decrease in chest tube drainage Widened cardiac silhouette on CXR |
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Managament of CAB
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Monitor PAC, CO, CVP, Ventricular filling pressures, SVO2, arterial line (continuous BP)
Weaning from ventilator Dangle pt on side of bed within 2hrs of extubation OOB to chair in 24-48hr |
