Signs + symptoms of flow limiting CAD
Questions
- Surface of mechanical valve increases risk of stroke, allows blood clots to form, what is it about this surface compared to tissue valves?
- Are there tissue/mechanical hybrid valves?
Things to write
- List of residents / people
- How to approach pre-op prep
Know neuro/resp/renal status - important for cardiac surgery
Talk to Melissa King - previous U of C student, current R1 UBC CV Sx, went unmatched
Dr. Smith did an MBA
Come up with reasons to do cardiac that can’t be contested by do cardiology
Program has rejected people for interviews that have:
- answered questions ahead of rounds
- charge nurse said no
VILID for prerounding
vitals, ins/outs, Labs, Investigations, Drugs
Half Day
Off Pump CABG (Amy)
CABG risks
Impella?
MIDCAB
- technically MI direct CAB (only LIMA → LAD), but MI CAB involves a lot
- indications/contraindications
Late filling angiogram - likely collateral?
- left thoracotamy 4th intercostal space
CBP
- 450 ACT
Daniel Svystnuk - R4?
Drugs (asa/beta/stata/pril/ogrel)
ASA -
Beta Blocker - will dec HR?
Statin -
Ace inhibitor - will dec HR?
P2Y12 - hold until 4-6 h post PW, ticagrelor vs plavix (ticagrelor better for everyone)
GI proph
DVTp
imdur if radial artery
Look for hemosiderin deposits for vein harvest, varicocities
rmbr dominant PDA has septals
pacing comes out day 3-4
Tube comes out < 150 in 24h ish, below 100 in last shift
check for edema, feel sternum (ask them to cough)
Know class 1a aortic valve replacement
- symptoms + severe echo findings
- severe echo + LV Fx < 50% asymptomatic
- already doing surgery
Know neuro / resp / renal studies → imp for surgery
read about IABP
plavix 5 days
ticagrelor 72h
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001168#sec-8
revasc guidelines