CSC Cardiac Surgery Sample 2

Question 1

Which cannulation site is preferred for arterial inflow in patients with severe ascending aortic atherosclerosis?

Accepted Answer

Axillary artery

Answer

The axillary artery is preferred in patients with porcelain aorta or severe ascending aortic atherosclerosis because it provides antegrade flow and avoids the diseased aorta.

Question 2

During mitral valve repair, the P2 scallop of the posterior leaflet is resected and reapproximated. What additional step is routinely performed to prevent systolic anterior motion (SAM)?

Accepted Answer

Ring annuloplasty

Answer

Ring annuloplasty reduces the annular diameter and remodels the mitral valve, which is essential to prevent SAM and ensure durable repair after posterior leaflet resection.

Question 3

A patient on cardiopulmonary bypass develops a sudden increase in arterial line pressure with decreased venous return. What is the most likely cause?

Accepted Answer

Venous air lock

Answer

Air entrained into the venous line creates a vapor lock that obstructs venous drainage, leading to high arterial pressure and decreased venous return to the pump.

Question 4

Which conduit has the best long-term patency for coronary artery bypass grafting to the left anterior descending artery?

Accepted Answer

Left internal mammary artery

Answer

The left internal mammary artery (LIMA) to LAD bypass has over 90% patency at 10 years, far superior to vein grafts, making it the gold standard conduit.

Question 5

In aortic valve replacement, what is the primary advantage of a sutureless bioprosthetic valve?

Accepted Answer

Reduced cross-clamp time

Answer

Sutureless valves are secured without individual sutures, significantly reducing aortic cross-clamp and cardiopulmonary bypass times, which benefits high-risk patients.

Cardiac Surgery Certification Exam Practice Test

Cardiac Surgery Certification Exam Practice Test

CSC Cardiac Surgery Sample 2