Cardiac Surgery Sample Flashcards
7 cards from real CSC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Cardiac Surgery Sample flashcards as text
A bicuspid aortic valve is most commonly associated with which concomitant aortic pathology?
Answer: Ascending aortic dilation
Bicuspid aortic valve is strongly associated with ascending aortic dilation due to shared genetic abnormalities in the aortic wall, independent of hemodynamic effects of valve dysfunction.
During minimally invasive mitral valve surgery via right mini-thoracotomy, what is the preferred method of aortic occlusion when the surgeon cannot reach the ascending aorta directly?
Answer: Endoaortic balloon occlusion catheter
An endoaortic balloon occlusion catheter (Heartport) placed via the femoral artery allows intraluminal aortic occlusion and antegrade cardioplegia delivery without direct aortic cross-clamping.
What is the most common indication for surgical repair of a ventricular septal defect (VSD) in adults?
Answer: Qp:Qs ratio >1.5:1 with symptoms
Adult VSD repair is indicated when the pulmonary-to-systemic flow ratio (Qp:Qs) exceeds 1.5:1 and is accompanied by symptoms or progressive ventricular enlargement.
Which cardioplegia strategy provides the longest safe period of myocardial protection during complex cardiac surgery?
Answer: Intermittent antegrade cold blood cardioplegia with retrograde supplementation
Combined antegrade and retrograde cold blood cardioplegia delivered at intervals provides uniform distribution to all myocardial territories, maximizing protection during prolonged procedures.
What is the mechanism of action of aprotinin in cardiac surgery?
Answer: Serine protease inhibition reducing fibrinolysis and platelet activation
Aprotinin is a broad-spectrum serine protease inhibitor that attenuates fibrinolysis, inflammatory activation, and platelet dysfunction associated with cardiopulmonary bypass.
In the Cox-Maze procedure for atrial fibrillation, what is the primary mechanism by which sinus rhythm is restored?
Answer: Creation of lesion lines that eliminate macro-reentrant circuits
The Maze procedure creates a series of surgical incisions or ablation lines that interrupt all potential reentrant circuits in the atria, forcing electrical impulses to travel in a single directed path from SA to AV node.
Which valve position carries the highest risk of prosthetic valve thrombosis if anticoagulation is subtherapeutic?
Answer: Mitral mechanical valve
Mitral mechanical valves have the highest thrombotic risk among prosthetic valves due to lower transvalvular gradients and higher stagnation of blood flow, requiring stricter INR targets.