Cardiac Surgery: Heart Anatomy and Bypass Machine

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Questions and Answers

Which of the following correctly describes the chambers of the heart?

One atrium and three ventricles

Two atriums and two ventricles (correct)

Three atriums and one ventricle

Four ventricles and no atriums

What is the purpose of the cardiopulmonary bypass machine during surgery?

To increase blood pressure in the patient

To cool the patient's body during the procedure

To enhance the heart's electrical activity

To temporarily replace the function of the heart and lungs (correct)

Which of the following is NOT considered in perioperative nursing for cardiac surgery?

Anesthesia administration

Instrumentation readiness

Patient recovery position

Post-surgical fitness training (correct)

What is the function of the chest drainage system in cardiac surgery?

To remove excess fluids and blood from the chest cavity Signup and view all the answers

Which of the following layers is the outermost layer of the cardiac wall?

Epicardium Signup and view all the answers

What is one major advantage of using the Left Internal Mammary Artery (LIMA) for grafting?

It is already attached to the aorta. Signup and view all the answers

Which of the following valves may require lifelong anticoagulant therapy if replaced with a mechanical valve?

Aortic Valve Signup and view all the answers

What layer is the middle layer of an artery called?

Tunica media Signup and view all the answers

What is one characteristic that differentiates veins from arteries?

Veins contain valves to prevent backflow of blood. Signup and view all the answers

What procedural consideration is essential during an emergency aneurysm repair?

Clamping the aorta should happen as soon as possible. Signup and view all the answers

Which of the following is a potential use for saphenous vein grafts?

Femoral Popliteal Bypass Signup and view all the answers

In abdominal aortic aneurysm (AAA) open repair, what is the surgical technique primarily used to prepare the area?

Isolation and clamping of the aorta Signup and view all the answers

What is the purpose of administering heparinized saline during vascular surgery?

To decrease the clotting ability of blood intra-operatively. Signup and view all the answers

Which procedure involves inserting an electronic device that can deliver shocks to the heart?

Implantable Cardioverter Defibrillator (ICD) Insertion Signup and view all the answers

What potential complication arises from an abdominal aortic aneurysm?

Severe hypotension Signup and view all the answers

What is the primary purpose of the venous cannula inserted into the right atrium during cardiopulmonary bypass?

To drain deoxygenated blood from the patient's body Signup and view all the answers

What component of cardiopulmonary bypass is used to warm or cool the patient's blood as needed?

Venous reservoir Signup and view all the answers

What effect does the delivery of cardioplegia have during a surgical intervention?

It induces cardiac arrest to protect the heart Signup and view all the answers

Which graft is considered the gold standard for coronary artery bypass grafting (CABG)?

Internal mammary artery Signup and view all the answers

What is a common complication that results in the need for defibrillation during cardiopulmonary bypass?

Cardiac arrhythmias after rewarming Signup and view all the answers

Study Notes

Heart Anatomy

The heart delivers deoxygenated blood to the pulmonary system and propels oxygenated blood into the circulatory system.
It is encased in the pericardial sac and consists of four chambers: right atrium, left atrium, right ventricle, and left ventricle.
Four main valves: tricuspid, pulmonary, mitral, and aortic valves.
Cardiac wall layers include epicardium, myocardium, and endocardium.

Perioperative Nursing Considerations

Key areas of focus: anesthesia, patient positioning, surgical count, instrumentation, blood replacement, and sutures.
Chest drainage system is inserted before closing the chest to relieve postoperative blood accumulation.

Cardiopulmonary Bypass (CPB)

Temporarily substitutes heart and lungs by diverting blood, allowing for heart arrest and manipulation.
The CPB machine has a heat exchanger (regulates patient temperature) and a filter (removes microemboli and debris).
Arterial cannula is inserted in the aorta to return oxygenated blood; venous cannula is placed in the right atrium to drain deoxygenated blood.

Surgical Interventions

Aortocoronary Bypass, known as Coronary Artery Bypass Grafts (CABG), is the gold standard treatment for Coronary Artery Disease (CAD).
Valve replacements or repairs are performed for conditions like valve stenosis, using either artificial (bioprosthesis) or mechanical valves.

Grafts Used in CABG

Internal Mammary Artery (IMA) provides excellent patency when grafting the Left Anterior Descending Coronary Artery.
Saphenous vein is often used when multiple grafts are necessary.
Radial artery is another option for grafting.

Valve Replacement/Repair

Required for conditions like valve stenosis which impedes blood flow.
May involve tricuspid, pulmonary, mitral, or aortic valves and can utilize mechanical or bioprosthetic materials.
Mechanical valves necessitate long-term anticoagulant therapy post-operation.

Vascular Anatomy

Arteries are thick-walled and elastic vessels that transport blood away from the heart, with three layers: tunica intima, tunica media, and tunica adventitia.
Veins are thin-walled, less elastic, and possess valves to prevent backflow, carrying blood towards the heart.

Vascular Prosthesis and Medications

Prostheses are employed for bypass procedures, including allografts and bovine pericardial patches.
Commonly used medications include heparinized saline as an anticoagulant, papaverine as a vasodilator, and contrast dye for vessel visualization.

Surgical Interventions in Vascular Surgery

Procedures include abdominal aortic aneurysm resection and repair, endovascular repair, femoral popliteal bypass, and pacemaker or ICD insertion.
Aneurysms are abnormal artery dilations resulting from trauma, disease, or congenital defects.

Abdominal Aortic Aneurysm Repair

Involves open repair by isolating the aorta, clamping, opening the aortic sac, and sewing in a graft.
Endovascular Aneurysm Repair (EVAR) utilizes x-ray guidance for critically ill patients, deploying stent grafts to augment the aorta.

Femoral Popliteal Bypass

Aims to restore or enhance blood flow to the legs due to plaque build-up within the femoral artery.
Grafts may be prosthetic or consist of the saphenous vein.

Pacemaker and ICD Insertion

Pacemakers involve electrodes placed in the heart to regulate rhythm, initiating contractions as needed.
Implantable Cardioverter Defibrillators (ICD) monitor cardiac activity, delivering shocks for dangerous arrhythmias while also capable of pacing.

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Description

This quiz focuses on cardiac surgery, covering key aspects such as heart anatomy and the functions of the cardiopulmonary bypass machine. You'll explore the anatomical structure of the heart, its four chambers, and essential procedural considerations for surgeons. Test your knowledge on these critical topics in cardiac surgery.