CSC Cardiac Surgery Sample 4

Question 1

A bicuspid aortic valve is most commonly associated with which concomitant aortic pathology?

Accepted Answer

Ascending aortic dilation

Answer

Bicuspid aortic valve is strongly associated with ascending aortic dilation due to shared genetic abnormalities in the aortic wall, independent of hemodynamic effects of valve dysfunction.

Question 2

During minimally invasive mitral valve surgery via right mini-thoracotomy, what is the preferred method of aortic occlusion when the surgeon cannot reach the ascending aorta directly?

Accepted Answer

Endoaortic balloon occlusion catheter

Answer

An endoaortic balloon occlusion catheter (Heartport) placed via the femoral artery allows intraluminal aortic occlusion and antegrade cardioplegia delivery without direct aortic cross-clamping.

Question 3

What is the most common indication for surgical repair of a ventricular septal defect (VSD) in adults?

Accepted Answer

Qp:Qs ratio >1.5:1 with symptoms

Answer

Adult VSD repair is indicated when the pulmonary-to-systemic flow ratio (Qp:Qs) exceeds 1.5:1 and is accompanied by symptoms or progressive ventricular enlargement.

Question 4

Which cardioplegia strategy provides the longest safe period of myocardial protection during complex cardiac surgery?

Accepted Answer

Intermittent antegrade cold blood cardioplegia with retrograde supplementation

Answer

Combined antegrade and retrograde cold blood cardioplegia delivered at intervals provides uniform distribution to all myocardial territories, maximizing protection during prolonged procedures.

Question 5

What is the mechanism of action of aprotinin in cardiac surgery?

Accepted Answer

Serine protease inhibition reducing fibrinolysis and platelet activation

Answer

Aprotinin is a broad-spectrum serine protease inhibitor that attenuates fibrinolysis, inflammatory activation, and platelet dysfunction associated with cardiopulmonary bypass.

Cardiac Surgery Certification Exam Practice Test

Cardiac Surgery Certification Exam Practice Test

CSC Cardiac Surgery Sample 4