| What are congential pathologies of heart? | Atrial septal defect (sinus venosus, secundum, caval)
Causes more flow to pulmonary artery than aorta, most common is secundum
Ventricular septal defect
Pulmonary Atresia (pulmonary artery closed early)
Aortic stenosis
Teratology of fallot (VSD, atresia, aortic valve disposition and ASD, might cause cyanosis called cynaotic congential heart defect)
Transposition of great vessels (not viable, 2alabo l large veessles, to live should have patent duct)
Patent Ductus arteriosus |
| What are acquired heart diseases? | CAD (atherosclerosis, infarction)
Valvular diseases (aortic stenosis (most common, types [rheumatic cause stenosis and regurg, calcific pure stenosis, bicuspid may be normal])
Aortic regurgitation [valve not closed completely]
Bicuspid valve, mitral stenosis, mitral regurgitation, tricuspid regurgitation)
Cardiomyopathy (dilated or hypertrophic [can be primary or acquired aortic stenosis])
Electrical block
Pericardial effusion |
| What are closed heart operations? | Ligation of Patent Ductus Arteriosus (midaxillary incision)
Off-pump coronary artery bypass
Pace maker implantation (Skin incision, Sub-clavian vein
puncture, Lead(s) introduction using Seldinger technique., Operative theater using a C-arm with Xray.)
Pericardiocentesis
Surgical drainage Pericardial window |
| What is cardiopulmonary bypass (Heart-lung machine)? | O2 poor blood leaves heart enters the machine, pumped added O2 blood to heart, goes to organs but skips heart and lungs |
| What are open heart operations? | Closure of ASD, VSD (patches)
Repair of pulmonary atresia, teratology of fallot (patch to enlarge pulmonary valve and RV outflow), transposition of great vessels |
| What is coronary artery bypass grafting (CABG)? | We take a part mostly of internal mammary artery (easy access) and less from gastro-epiploic artery (GEA) and rarely radial artery.
We may take greater and lesser saphenous vein grafts
Do coronary anastomosis, so we get arterial CABG
We may also do venous CABG (in case we do 4 CABGs)
Atypical CABGs (LIMA-LAD, LIMA-Dg-LAD, SV-Mg) |
| What are valve replacements? | Two types Biological and mechanical
Biological (stentless or stented [porcine/pericardial valve])
Mechanical (tilting disc or bileaflet)
We may have aortic valve replacement, aortic valve repair [if floppy valve leaflet], mitral valve replacement or repair, tricuspid valve repair |
| How are interventions of myocardial HF? | Intra-Aortic Balloon Pump, ECMO, LVAD: Centrifugal pump, BiVAD: Totally implantable heart
If no recovery: Go for Heart Transplant (Donor heart harvesting, Recipient heart explantation, Suturing LA, vena cava and great vessels |
