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📘 Cardiothoracic Surgery Study Guide

🫀 Cardiovascular Anatomy & Physiology

• Thickest part of the heart: Myocardium

• Pacemaker of the heart: SA Node

• Heart Valves:

  • Tricuspid (right atrium → right ventricle)

  • Pulmonary (right ventricle → lungs)

  • Mitral/Bicuspid (left atrium → left ventricle)

  • Aortic (left ventricle → aorta)

• Correct blood flow through heart and lungs:
  Right atrium → Right ventricle → Pulmonary artery → Lungs → Pulmonary vein → Left atrium → Left ventricle → Aorta

🫁 Thoracic Procedures & Conditions

• Bleb: Air-filled sac on lung surface

• Cardiopulmonary Bypass:

  • Stops heart: Potassium chloride (KCl)

  • Air displacement: Carbon dioxide (CO₂)

  • Maintained circulation: Heart-lung machine components:

    • Pump

    • Oxygenator

    • Heat exchanger

  • Not a component: Defibrillator

  • Support if bypass weaning fails: Intra-aortic balloon pump (IABP)

🧪 Diagnostic Procedures

• Cardiac catheterization: Best for evaluating valve and coronary artery conditions

• Mediastinoscopy: Biopsy mediastinal tumors (thymomas, cysts)

• Bronchoscopy: No incision required

• MRI/CT: Imaging but not as detailed for valves as catheterization

👶 Congenital Defects

• Tetralogy of Fallot: 4 defects; causes cyanosis in infants ("blue baby")

• Patent Ductus Arteriosus (PDA): Persistent fetal connection between pulmonary artery & aorta

• Septal defects (ASD, VSD): Holes in atrial or ventricular septum

🔧 Surgical Procedures

💉 Heart Valve Replacement

• Biologic valve lifespan: 10–15 years

• Mechanical valve: Longer lifespan, requires anticoagulation

⚠ Peripheral Vascular Disease (PVD)

• Complications if untreated:

  • Stroke

  • MI (heart attack)

  • Hypertension

  • Bleeding

  • Clot formation