Cardiac Surgery And Intervention

1.

When is CABG indicated?
- A.
  
  LCA stenosis
- B.
  
  Need for heart or other major surgery
- C.
  
  Osteal or calcified lesions
- D.
  
  Major complication in cath lab
- E.
  
  Failure of stenting
- F.
  
  Severe and diffuse disease (diabetes, renal disease, poor ventricular function)
- G.
  
  All of the above
Correct Answer
G. All of the above

Explanation
CABG (Coronary Artery Bypass Grafting) is indicated in various situations. LCA stenosis refers to narrowing of the left coronary artery, which can be a reason for CABG. The need for heart or other major surgeries can also indicate the requirement for CABG. Osteal or calcified lesions, major complications in the cath lab, and failure of stenting are other situations where CABG may be indicated. Additionally, severe and diffuse disease, especially in cases of diabetes, renal disease, and poor ventricular function, can also necessitate CABG. Therefore, all of the above situations indicate the need for CABG.

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2.

What is the benefit of IMA?
- A.
  
  Long term patency is better
- B.
  
  Fewer subsequent procedures
- C.
  
  Conduit limited availability
- D.
  
  Surgery more demanding
- E.
  
  Increases would infection
- F.
  
  All of the above
Correct Answer
F. All of the above

Explanation
The benefit of IMA (Internal Mammary Artery) includes long-term patency, which means that the artery remains open and functional for a longer period. This leads to fewer subsequent procedures as there is no need for additional surgeries or interventions to address blockages or complications. Additionally, IMA has a limited availability as it can only be used in certain patients and situations. The surgery to use IMA is more demanding compared to other procedures. Lastly, the use of IMA can increase the risk of infection. Therefore, all of the mentioned options are benefits of IMA.

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3.

All of the following are advantanges of CABG except
- A.
  
  Longer term benefit
- B.
  
  Double platelet therapy not required
- C.
  
  Fast recovery
- D.
  
  Risk of surgical complication
Correct Answer
C. Fast recovery

Explanation
slow recovery

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4.

All of the following of CABG surgery
- A.
  
  Bleeding
- B.
  
  Graft occlusion or stenosis
- C.
  
  Infection
- D.
  
  Heart failure
- E.
  
  Arrythmias
- F.
  
  Venous thrombosis, Pulmonary embolism
- G.
  
  All of the above
Correct Answer
G. All of the above

Explanation
The correct answer is "all of the above." This means that all of the mentioned conditions, including bleeding, graft occlusion or stenosis, infection, heart failure, arrhythmias, venous thrombosis, and pulmonary embolism, can occur as complications of CABG surgery.

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5.

What are the indications of mitral valve disease
- A.
  
  Mitral stenosis cross sectional area 1-1.5 cm
- B.
  
  Mitral regurgitation: impaired LV
- C.
  
  MR: dyspnea, weakness, palpitation
- D.
  
  LV dimension greater than 6 cm
- E.
  
  LA greater than 4.5 cm
- F.
  
  All of the above
Correct Answer
F. All of the above

Explanation
The given correct answer is "all of the above". This means that all of the listed indications are signs of mitral valve disease. Mitral stenosis is indicated by a cross-sectional area of 1-1.5 cm, mitral regurgitation is indicated by impaired left ventricle, and symptoms such as dyspnea, weakness, and palpitation are associated with mitral regurgitation. Additionally, an enlarged left ventricle dimension greater than 6 cm and an enlarged left atrium greater than 4.5 cm are also indications of mitral valve disease.

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6.

Prosthetic valves can be porcine or mechanical with the tissue valve being more durable and noisy
- A.
  
  True
- B.
  
  False
Correct Answer
B. False

Explanation
tissue valve are mostly porcine, and don't need anticoagulation, it is silent but usually fails in 8-15 years

mechanical valves are more durable, noisy, requires anticoagulation and careful lab monitoring

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7.

The complication of Heart Valve Surgery includes
- A.
  
  Prosthetic Valve Endocarditis
- B.
  
  Thrombosis and thromboembolism
- C.
  
  Bleeding from poorly regulated anticoagulation therapy
- D.
  
  Perivalvular leak
- E.
  
  Degeneration and calcification of valve leaflets
- F.
  
  All of the above
Correct Answer
F. All of the above

Explanation
Heart valve surgery is a complex procedure that involves replacing or repairing damaged heart valves. Complications that can arise from this surgery include prosthetic valve endocarditis, which is an infection of the artificial valve; thrombosis and thromboembolism, which are blood clotting disorders; bleeding from poorly regulated anticoagulation therapy, which is the medication used to prevent blood clots; perivalvular leak, which is a leakage around the valve; and degeneration and calcification of valve leaflets, which is the deterioration of the valve over time. Therefore, all of the mentioned complications can occur after heart valve surgery.

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8.

Who should have a PTCA without a stent
- A.
  
  Pts with lesions in small vessels
- B.
  
  Pts who need heart surgery
- C.
  
  Pts in dangerous occupation
- D.
  
  Pts who have difficulty with medication compliance
- E.
  
  All of the above
Correct Answer
E. All of the above

Explanation
All of the above options are valid reasons for a patient to undergo PTCA (percutaneous transluminal coronary angioplasty) without a stent. Patients with lesions in small vessels may benefit from PTCA without a stent as it can help improve blood flow. Similarly, patients who need heart surgery may undergo PTCA without a stent as a temporary measure before their surgery. Patients in dangerous occupations may also opt for PTCA without a stent to reduce the risk of complications. Lastly, patients who have difficulty with medication compliance may choose PTCA without a stent as an alternative treatment option.

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Cardiac Surgery And Intervention

When is CABG indicated?

What is the benefit of IMA?

All of the following are advantanges of CABG except

All of the following of CABG surgery

What are the indications of mitral valve disease

Prosthetic valves can be porcine or mechanical with the tissue valve being more durable and noisy

The complication of Heart Valve Surgery includes

Who should have a PTCA without a stent