| What are CAD Risk Factors and Endothelial Dysfunction: Oxidative Stress is a Common Mechanism? | . |
| How are fatty streaks forming atherosclerosis? | Fatty streaks initially consist of lipid-laden monocytes and macrophages (foam cells) together with T lymphocytes
Pathology finding (fibrous cap, macrophages/Tcells, lipid core and media under it)
Fibrous cap if it is thick, w/smaller lipid pool and fewer inflammatory cells it is stable plaque, if thin cap, large lipid pool few smooth muscle cells then unstable/vulnerable plaque |
| What is positive remodeling ? | • The arterial lumen will not be affected before the
plaque gets to 40% of the arterial surface.
• Atherosclerosis is a vascular wall disease and
not a vascular lumen disease |
| How is atherosclerosis and age? | . |
| What are consequences of atherosclerosis? | Plaque rupture causes MI, if atherosclerosis w/out sx: leads to angina/ STEMI or NSTEMI and becomes sx
Thrombosis and complete occlusion of coronary artery
Posterior dominance of heart wall coronary artery may be co dominanace/right/left
Can be seen by coronary scanner/angiography
After 40 mins little area of necrosis, litlle ischemia, after 3 hours more necrosis, after 96 hours half is necrotic |
| What are operations for atherosclerosis? | Percutaneous Transarterial Coronary Angioplasty (PTCA), Balloon angioplasty with stent implantation (self-expandable/balloon expandable), Revascularization of LAD occlusion/RCA occlusion, Thromboaspiration of RCA Arterial grafts harvesting from IMA/GEA/Radial artery Greater and Lesser Saphenous Vein grafts, Coronary Anastomosis, Arterial CABG |
| What are indications for CAD? | . |
| CABG vs PTCA? | . |
| What are indications for surgery in CAD? | • Left main stenosis.
• Triple-vessel disease.
• Bifurcation plaque.
• Intra-stent restenosis.
• Unsuccessful stent implantation.
• Total occlusion of an artery.
• Other
Either classic sternotomy incision or minimally invasive CABG |
