Cardiovascular Anesthesia Flashcards
7 cards from real BCA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Cardiovascular Anesthesia flashcards as text
Which cardioplegia delivery method provides the most uniform myocardial protection in the presence of significant coronary artery disease?
Answer: Combined antegrade and retrograde delivery
Combined antegrade and retrograde delivery ensures distribution to areas that may not receive adequate cardioplegia through stenotic coronary arteries alone.
The normal activated clotting time (ACT) target for full anticoagulation during cardiopulmonary bypass is:
Answer: >400 seconds
An ACT >400 seconds (some centers use >480 s) is required to prevent thrombus formation within the CPB circuit.
A patient develops acute right heart failure immediately after separation from CPB following mitral valve repair. The FIRST intervention should be:
Answer: Administer inhaled nitric oxide to reduce PVR
Inhaled nitric oxide selectively reduces pulmonary vascular resistance, directly unloading the right ventricle without causing systemic hypotension.
Which ECG finding during cardiac surgery indicates adequate diastolic arrest with cold potassium cardioplegia?
Answer: Flat isoelectric line (asystole)
Cardioplegia depolarizes myocardial cells by elevating extracellular potassium, causing diastolic arrest manifested as an isoelectric ECG.
During aortic arch surgery with circulatory arrest, cerebral protection is best achieved by:
Answer: Antegrade selective cerebral perfusion with moderate hypothermia
Antegrade selective cerebral perfusion (ASCP) with moderate hypothermia (24-28°C) provides direct cerebral blood flow and metabolic suppression, offering superior neuroprotection.
Milrinone is preferred over dobutamine for right ventricular failure post-cardiac surgery primarily because:
Answer: Milrinone reduces PVR while increasing RV contractility
Milrinone, a phosphodiesterase-3 inhibitor, simultaneously increases inotropy and causes pulmonary vasodilation, directly addressing both components of RV failure.
Which intraoperative finding on TEE most reliably indicates adequate de-airing of the left ventricle before cross-clamp removal?
Answer: Absence of echogenic particles in LV cavity and aorta
Absence of echogenic (bright) particles in the LV cavity and ascending aorta on TEE confirms adequate de-airing, reducing risk of air embolism.