Transcript cardiothoracic procedures

CARDIAC
PERIPHERAL VASCULAR
BRAIN / HEART CONNECTION
HEART ANATOMY REVIEW
• SURROUNDS THE HEART
• PERICARDIUM
• PARTITIONS RIGHT AND LEFT SIDES
• SEPTUM
• 4 DISTINCT HEART DIVISIONS
• CHAMBERS
HEART FLOW CONTROLS
• ALLOW DIRECTIONAL BLOOD FLOW
PREVENTING BACKFLOW
• VALVES
• HEART’S RIGHT SIDE
• PULMONARY & TRICUSPID – 3 CUSPS
• HEART’S LEFT SIDE
• AORTIC & MITRAL (BICUSPID)
PATHY ….What can go wrong?
• CONGENITAL ANOMALIES
• CORONARY BLOCKAGE/IMPAIRMENT
• VALVULAR DISORDERS
• ANEURYSMS
• THYMOMA – TUMOR OF THYMUS
VEINS
• BLOOD FROM UPPER BODY
LOWER BODY
• SUPERIOR VENA CAVA
• INFERIOR VENA CAVA
• OXYGENATED BLOOD TO HEART
FROM LUNGS
• PULMONARY VEINS
ARTERIES
• BLOOD TO LUNGS FOR OXYGEN
• PULMONARY ARTERIES (R & L)
• OXYGENATED BLOOD TO HEART
• CORONARY ARTERIES (R & L)
• BUILDUP OF CHOLESTEROL FATS
• PLAQUE
"HARDENING OF THE ARTERIES”
• ATHEROSCLEROSIS
RISK FACTORS OF CAD
• NO CONTROL
• Gender
• Age
• Heredity
• CAN CONTROL
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High blood pressure
Smoking
High cholesterol levels
Lack of proper exercise
Body weight
Diabetes
Stress
Poor Diet
CAD SYMPTOMS
• PAIN – CHEST, NECK AND/OR ARMS
• DURATION - 3 TO 5 MINUTE OR LONGER
• RESULTS - OXYGEN DEPRIVATION
• OUTCOME - HEART ATTACK
http://www.nhlbi.nih.gov/health/dci/Diseases/Angiopl
asty/Angioplasty_During.html
CAD TRIGGERS
• PHYSICAL EXERTION
• EATING
• CHANGES IN TEMPERATURE
• EXTREME EMOTION
• AT REST
CABG IMAGE
CABG = Acronym for ?
• OXYGEN RICH BLOOD TO HEART MUSCLE
• LIFESPAN = 10 TO 12 YEARS
• HARVEST :
•
VEIN - GREATER SAPHENOUS
ARTERY – INTERNAL MAMMARY
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RADIAL ARTERY
THROMBOSIS – What is it?
HEART VALVE ANATOMY
HEART VALVE PROBLEMS
• REGURGITATION or INSUFFICIENCY
– Pulmonary venous HTN
– CHF
• STENOSIS
– Ventricular hypertrophy
– CHF
VALVE FACTORS
• AGE
• ANTICOAGULANT USE
• OCCUPATION
• HEART FUNCTION & RHYTHM
• VALVE SIZE & # NEEDED
STERNOTOMY & MIS
NORMAL HEARTBEAT
• STARTS NORMAL HEARTBEAT
• Sinoatrial (SA) node
• RECEIVES IMPULSE
• Atrioventricular (AV) node
• AV NODE TRIGGERS WHAT?
• Ventricular contraction
• NORMAL HEARTBEAT RATE
• 60 – 80 times a minute!
CARDIAC DYSRHYTHMIA
• Interruption of electrical conductivity
between atria and ventricle
• HEART BLOCK
• Slow, fast or irregular heartbeats
• ARRHYTHMIA
• SLOW = BRADYCARDIA = < 60 bpm
• FAST = TACHYCARDIA = > 100bpm
• Irregular, disorganized electrical activity
• ATRIAL FIBRILLATION
MAZE INSTRUMENTS
CARDIAC DIAGNOSTICS
• Catheter advanced from Brachial/Femoral
artery to heart or coronary artery
• CARDIAC CATHETERIZATION
• RECORD ELECTRICAL VARIATIONS
• EKG
• Ultrasound views cardiac structure/motion
• ECHOCARDIOGRAM
• Endoscopic viewing of cardiac grafts, perfusion,
valves, ventricular function
• TEE ( transesophageal echocardiogram)
LAB STUDIES
• CARDIAC ENZYMES
• BLOOD WORK
• ARTERIAL BLOOD GASES
SPECIAL EQUIPMENT
• THERMISTOR
• AUTO TRANSFUSER
• SLUSH
• CINE MACHINE
HEART FAILURE
• WHO HAS IT? - 1-2% U.S. Populous = 4.9 million
• WHAT CAUSES IT? ---–
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Cardiomyopathy
Diabetes
Valvular Disease
Pericardial Diseases
Continuous Tachycardia
MI
HTN
• http://www.bing.com/videos/watch/video/n
ejm-procedure-deployment-of-anendovascular-graft-inan/128611DDD591396E3987128611DDD
591396E3987?q=abdominal+aortic+aneur
ysm+surgery&FROM=LKVR5&GT1=LKVR
5&FORM=LKVR27
CAROTIDENDARTERECTOMY
• http://www.videomd.com/CarotidEndartere
ctomy-fv-560.aspx
• http://www.cts.usc.edu/videos.html
• http://www.vascularsurgery.org.uk/index.p
hp?option=com_content&view=section&la
yout=blog&id=12&Itemid=110
• http://www.wesleymooremd.com/video/
• http://www.bing.com/videos/search?q=vas
cular+surgery+video+clips&qpvt=vascular
+surgery+video+clips&FORM=VDRE&adlt
=strict
• http://quizlet.com/6239001/surgical-technologych-23-peripheral-vascular-surgery-flash-cards/
• http://www.pluromed.com/legoo_clinical_ex.htm
• http://www.rush.edu/rumc/page-R11815.html
• http://www.youtube.com/watch?v=Zxqj1BcBpIg
• http://www.ctsnet.org/sections/clinicalresources/
videos/index.html
• http://www.smm.org/heart/videos/top.html#bypa
ss
• http://www.provena.org/mercy/body.cfm?id=957
• http://www.vascularprocedures.com/html/caroti
d/axillofemoral.php
• http://www.youtube.com/watch?v=ksjhfw_
Pcx8