Cardio terms, perfusion, etc

MEDICAL AND SURGICAL INTERVENTION FOR CONGENITAL AND ACQUIRED DISEASE / CARDIOLOGY

 

Intervention Pathology Description
Ablation of SV arrhythmic focus Dysrhythmiogenic foci – reentrant loops – accessory pathways High energy direct current shocks or cold cryoablation — resection —- laser
AICD placement Tachydysrrhythmias Placement of internal or external leads that send a high voltage short duration shock to the cardiac muscle when HR > 250 beats/min or ventricular fibrillation is sensed
Aneurysmectomy LV aneurysm Incision into aneurysm — widely opened — a dacron patch is sewn over the orifice and redundant portions of aneurysm free edges are excised. Remnant aneurysm closed over the patch for hemostasis & to minimize adhesions
angioplasty Coronary Artery Disease (CAD) or Atherosclerosis (AS) Small balloon tipped catheter inflated at site of stenosis to compress the fatty deposits against the lumen of the arterial wall
Annuloplasty Mitral or Tricupid valvular disease Prosthetic repair of a valve annulus using a synthetic ring to reshape or resize valve area
Anomalous Coronary Artery Repair Congenital anomalous connection or origin of a coronary artery Intra-pulmonary artery tunnel created with PA tissue which connects the anomalous origin to a side to side Aorta to PA anastomosis. The PA section that was used as a tunnel is closed with a pericardial patch
Aortic Aneurysm Repair (Aortic Arch) Aneurysm,Dissection or Tear Repair by either direct closure, excision of aneurysm tissue and/or placement of a woven dacron cylinder
Aortic Aneurysm Repair (Ascending Aorta) Aneurysm, dissection or tear with or without involving valve Replacement of root with woven dacron tube graft or if involves valve — Bentall or Cabrol operation with a valved conduit where coronaries have to anastomosed to lumen of conduit
Aortic Aneurysm Repair (Descending Aorta) Aneurysm, Dissection or Aortic Tear, beyond the aortic arch Diseased section excised or resected; conduit placed — can be performed via left thoracotomy however many institutions are using ECC with DHCA
Aortic Valve Replacement (AVR) Aortic valvular incompetence (AI) or aortic valvular stenosis Excision of native valve through aortotomy in aortic root. Replacement with an allograft, autograft (see Ross Procedure), or prosthetic valve (mechanical or heterograft)
Aortoplasty for Supravalvular Stenosis AS or congenitally narrowed aortic root Resection and or patch enlargement of the aortic root and or valve area using – an inverted “Y” patch is often used
Arterial Switch Operation Transposition of the Great Arteries (TGA) or Taussig-Bing Heart 1. PDA is closed 2. Aorta and main PA transected close to valve region 3. R and L coronary ostia buttons are excised from proximal aorta and anatomosed to the proximal PA trunk 4. Pericardium is used to fill defects left in prox. aorta 5. End to end anastomoses of PA trunk to distal aorta and proximal aorta to PA 6. Any intracardiac shunts are closed
Arteriovenous Chamber Fistula Repair Congenital anomaly of the coronary arteries Fistula is closed with or without cardiopulmonary bypass depending on where the fistula opens or terminates
ASD Repair Atrial Septal Defect or any anomaly with which it is associated Patch (pericardial, dacron or GoreTex) or direct suture closure of communication between LA and RA
Atherectomy CAD or AS Similar to angioplasty except the obstruction is actively shaved or cut away with small blades or rotors
AV Canal Repair Partial or complete AV canal Continuous patch to VSD (in complete) and ASD (in complete & incomplete) with repair, resuspension and/or separation of the atrioventricular valves – may perform annuloplasty or replacement of mitral valve depending on complexity of defect
Blalock-Hanlon Shunt (BT shunt) Complex lesions or TGA Atrial septectomy through open incision where shunting and mixing of blood at the atrial level is necessary for survival and growth
Blalock-Taussig Shunt / Modified TOF or cyanotic lesions with compromised pulmonary flow Palliative procedure to increase pulmonary blood flow – subclavian artery is taken down and anastomosed end to side of RPA. The modified version to is place a 3,4 or 5 mm GoreTex graft between subclavian & RPA — can be performed on left side
CABG(LIMA, RIMA, GEA, SVG, radial a. etc) CAD or AS Autograft conduits ( LIMA, RIMA, GEA, SVG etc) are harvested from the body and used to bypass stenotic lesions on the heart. The distal end of the graft is sewn on the coronary distal to the stenosis or diseased portion and the proximal end is anastomosed to the aorta or left attached to the systemic arterial system
Coarctation of Aorta Repair Coarctation or narrowing of the aorta 1. Subclavian is ligated and opened and used as a flap to widen the aorta where an incision at the site of coarctation has been made 2. the narrowed portion is excised and the aorta is reattached via an end to end anastomosis
Commissurotomy Stenotic or fused commissures on the mitral, tricuspid or aortic valve Surgical incision or digital disruption of the components of the commissures to increase the valve area or the orifice size
Cor Triatriatum Repair Cor Triatriatum Dexter or Sinister Excision of abnormal membrane in atria and closure of the ASD
Damus-Kaye-Stansel (DKS) Double Inlet Left Ventricle (DILV); atretic aortic valve 1. Main PA transected just proximal to the bifurcation of the PA branches; 2. Oversewn distal PA 3. Anastomosis of proximal mPA to ascending aorta using an appropriately shaped hood created from a preclotted woven dacron tube/pericardium/allograft/xenograft or GoreTex to complete the anastomosis
Ebstein’s Repair Ebstein’s Malformation Closure of ASD (see ASD Repair) and repair of tricuspid valve: Repair involves plication of the atrialized portion of the ventricle, narrowing the TV orifice resulting in a monoleaflet TV.
Endarterectomy CAD or AS Surgical removal of clot or atherosclerotic plaque through a longitudinal incision in an artery wall
Fontan Aortic atresia; complex AV canal; DILV; DORV; DOLV; pulmonary atresia; tricuspid atresia; VSD with overriding AV valves; 1. see Norwood or DKS or BT shunt for first stage 2. see Glenn shunt or Hemi-Fontan for second stage 3. A convex piece or dacron tube, GoreTex or pericardium is used to create an interatrial tunnel from IVC opening to SVC opening in right atrium so that all venous return will enter previously created caval – pulmonary shunt —- Fenestrated –
Glenn Shunt Procedure – cavopulmonary connection see Fontan 1. see Norwood, DKS or BT shunt for first stage procedure 2. SVC transected 2. proximal SVC sewn end to side anastomosis to underside of R pulmonary artery 3.distal SVC sewn end to side anastomosis to top of RPA
Heart Transplantation Cardiomyopathy — irreversible congestive heart failure (CHF) A donor heart is harvested and transplanted into the recipient after the diseased organ has been excised
Heart-Lung transplantation Cardiomyopathy and irreversible pulmonary dysfunction The heart and lungs are harvested en bloc from the donor then transplanted into the recipient en bloc after the diseased organs have been excised
Hemi-Fontan see Fontan 1. see Norwood, DKS or BT shunt for first stage palliation 2. 2nd stage palliation involves division of SVC flow to the RPA by creating a R atriopulmonary anastomosis; An ASD is created and any systemic-pulmonary shunts are closed; a pulmonary allograft is used to create a wide pathway and a hood for the atrialcaval anastomosis; a patch is then sewn into place inside the RA to deny IVC, pulmonary venous, and coronary sinus blood access topathway but allows SVC blood to flow freely to PAs
Interrupted Aortic Arch repair No connection between ascending and descending aorta Palliative: PA band (see PA Band ) and PGE1 for patency of PDA, corrective: restore continuity by insertion of synthetic conduit or direct end to end anastomosis
Konno procedure Congenital aortic stenosis Vertical aortotomy just distal to valve into RV; vertical incision into the ventricular septum near aortic valve; the stenotic valve is excised – a prosthetic valve is sewn into place; a “V” patch is sewn into the ventricular septum to enlarge the LV outflow tract and sutured so as to close the aortotomy. A pericardial patch is used to close the R ventriculotomy and sewn onto aorta just outside the other suture line
Laser atherectomy CAD or AS Laser beam is used to remove and disintegrate existing atheroma to reopen the lumen
Liver Transplantation Congenital or Acquired Liver Disease or Failure Diseased liver is excised and donor liver is transplanted
Lung Transplantation Aquired lung disease Diseased lung(s) is (are) excised and donor lung is transplanted
Mitral Valve Replacement Mitral stenosis (MS) or mitral regurgitation (MR) Diseased or calcific mitral valve excised through left atrial incision – a prosthetic valve or bioprosthesis is sewn into place — the LA is closed
Mustard Procedure (atrial switch) TGA An oblique right atriotomy is created; the atrial septum in excised; a pericardial baffle is sutured to incorporate the pulmonary veins into the RA and another baffle is sutured to direct SVC and IVC return into the LA & MV
Myomectomy for IHSS IHSS Resection of an abnormal muscle bundle
Norwood Aortic Atresia; HLHS; single ventricle First stage palliation to ensure pulmonary vascular resistance has fallen to normal before a definitive Fontan is performed: 1. close PDA 2. divide main PA and oversew distal portion 3. longitudinal incision made from aortic root to proximal ascending aorta 4. enlarge aorta with a curved allograft patch 5. suture proximal main PA to aorta and allograft 5. modified BT shunt placed
PA Band AV Canal; DILV; DORV; DOLV; TGA; TA Palliative procedure in which a dacron impregnated silastic tape is placed around the circumference of the PA and tightened to increase pulmonary resistance and limit pulmonary blood flow
Pacemaker Insertion Dysrrhythmias; Arrhythmias A device which provides timed electrical stimuli to the heart muscle which consists of a pulse generator (internal & external) and conduction leads — these leads can be epicardial or endocardial
PAPVR Repair Incomplete or partial anomalous pulmonary venous return Closure of ASD with direction or connection of pulmonary veins into the left atrial cavity
PDA Repair PDA or any defect in which this anomaly is associated The patent ductus arteriosus if isolated in approached via a thoracotomy and either ligated or divided
Penetrating Cardiac Trauma Intrusion of the any of the heart cavities with a foreign object Object is removed, bleeding is controlled and penetrating wound is repaired
Pericardectomy Chronic constrictive or effusive pericarditis Longitudinal incision is made in the thickened pericardium and flaps are dissected back to expose and free the left and right ventricles — pericardium is also freed from diaphragm
Post-infarct VSD Repair CAD or AS see VSD repair
Potts-Smith Shunt TOF with pulmonary stenosis Systemic to pulmonary artery shunt created a side to side anastomosis of the descending aorta to the left pulmonary artery
Pulmonary Outflow Tract Augmentation TOF with PS see TOF repair
Rashkind Procedure Any anomaly or defect where a palliative atrial level communication is necessary for survival and growth Balloon atrial septectomy usually performed in the catherization lab
Rastelli Procedure DORV type TGA; VSD; Left Ventricular Outflow Tract Obstruction RV opened through vertical incision; VSD is enlarged by incision; pulmonary valve is sutured closed; an intraventricular tunnel is created to direct LV blood flow to Aorta; an allograft valved extracardiac conduit is anastomosed from the RV outflow tract to the distal PA trunk
Ross Procedure Aortic Valve Disease – usually congenital Replacement of aortic valve (resected and excised) with an autograft pulmonary valve cylinder; the autograft walls opposite the L and R coronary ostia are scalloped and sewn into aortic root; the pulmonary valve is absent and the two transected ends are reanastomosed
RV to PA conduit Pulmonary outflow tract obstruction/stenosis An allograft valved or synthetic extracardiac conduit is anastomosed from the RV outflow tract to the distal PA trunk
Senning Procedure (atrial switch) TGA L and R atriotomies are performed; A septal patch is created from the interatrial septum and sewn to incorporate the pulmonary veins into the RA; The free edge of the RA is sutured to the posterior edge of the atrial septal wall and the R atrial central free flap is sutured to the right lateral LA incision so that venous return flows into the LA.
Sinus of Valsalva Repair Sinus of Valsalva Aneurysm Aortic root opened transversely; RV opened; the aneurysm is excised and a patch is used to repair the excision site and close the VSD
Stent Placement CAD or AS Stent fits over the PTCA or angioplasty catheter; Balloon is inflated to compress the atheroma and the stent is expanded to permanently open the vessel
Takeuchi Repair Origin of L coronary artery from the PA see Anomalous Coronary Artery Repair
TAPVR Repair Total anomalous pulmonary venous return PDA is closed; If connections are infra or supracardiac anastomoses are made between contiguous LA and structure where the veins drain — if drain to the coronary sinus — incorporated into the LA via a patch
TOF or POF Repair Tetralogy or Pentalogy of Fallot PDA ligation if patent; VSD baffle closure to incorporate overriding aorta onto left side of patch; ASD closure if POF; and transannular patch to widen stenotic outflow tract or valve
Tricuspid Valve Replacement Tricuspid Incompetence (TI); Tricuspid stenosis Valve excised – a stent mounted human semilunar valve seems to be the most ideal and durable
Truncus Arteriosis Repair Truncus Arteriosis Pulmonary arteries (PA) are divided from the truncus, and connected to the RV by a tube graft – defect in the aorta is repaired – VSD is repaired – truncal valve is evaluated and repaired if necessary,
Tumor Excision of Intra or Extracardiac Benign or cancerous tumors Open heart or extracardiac structure and excise tumor and as much of its extensions as possible
Valvuloplasty MV or TV regurgitation or cleft mitral valve Chordae tendinae supporting posterior cusp of mitral valve are shortened or wedge resection of affected part of cusp
Valvuloplasty with Ring see Annuloplasty
Vascular Ring Repair Vascular Ring or Sling The right arch running behind the esophagus is divided closed to its junction with the descending aorta and the ends are oversewn
VSD Repair Congenital or acquired post myocardial infarction Patch closure through right atrium or right ventriculotomy if difficult to visualize from atrium
Waterston shunt TOF with pulmonary stenosis Systemic to pulmonary shunt via side to side surgical anastomosis of the ascending aorta to the right pulmonary artery

GLOSSARY OF TERMS AND ACRONYM EXPANSIONS FOR PERFUSION TECHNOLOGY, OPEN HEART SURGERY AND CARDIOLOGY

LINK: http://www.musc.edu/perfusion/glossary.htm or click the words in blue and they will lead you to the link…

Who wants an extreme medical dictionary aside from Stedman? or an instantext program as an add-ins like smarttype?

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