Cardiac Surgery Certification Exam Aortic Surgery and Mechanical Circulatory Support 1

Question 1

The DeBakey classification of aortic dissection Type I involves:

Accepted Answer

Dissection originating in the ascending aorta and extending into the descending aorta

Answer

DeBakey Type I dissection begins in the ascending aorta and propagates distally through the arch and into the descending aorta, requiring emergency surgery.

Question 2

Stanford Type A aortic dissection requires emergency surgery primarily because of the risk of:

Accepted Answer

Pericardial tamponade, aortic regurgitation, and coronary ostial involvement

Answer

Type A dissection threatens the proximal aorta, risking rupture into the pericardium (tamponade), aortic valve disruption, and coronary ostial dissection causing acute MI.

Question 3

Deep hypothermic circulatory arrest (DHCA) is used in aortic arch surgery primarily to:

Accepted Answer

Provide a bloodless operative field while protecting the brain and organs during circulatory pause

Answer

DHCA cools the patient to 15–20°C, dramatically reducing cerebral metabolic demand and allowing safe cessation of circulation for arch reconstruction.

Question 4

Which technique can extend the safe duration of circulatory arrest during aortic arch surgery beyond DHCA alone?

Accepted Answer

Selective antegrade cerebral perfusion (SACP)

Answer

SACP delivers oxygenated blood directly into the cerebral vessels during circulatory arrest, extending safe arch reconstruction time beyond the limits of DHCA alone.

Question 5

The Bentall procedure is performed for:

Accepted Answer

Aortic root aneurysm with aortic regurgitation, replacing the root, valve, and reimplanting coronary buttons

Answer

The Bentall procedure replaces the aortic root with a composite graft (valve + ascending aorta), with reimplantation of the coronary ostia as buttons into the graft.

Cardiac Surgery Certification Exam Practice Test

Cardiac Surgery Certification Exam Practice Test

Cardiac Surgery Certification Exam Aortic Surgery and Mechanical Circulatory Support 1