CSC Cardiac Surgery Sample 5

Question 1

After aortic valve replacement, a patient develops new complete heart block. Which anatomic structure is most likely injured?

Accepted Answer

Left bundle branch near the membranous septum

Answer

The left bundle branch courses along the base of the non-coronary and right coronary cusp region of the membranous septum and is at risk during deep suture placement in aortic valve replacement.

Question 2

A patient requires redo sternotomy for mitral valve replacement. What is the greatest risk during sternal re-entry?

Accepted Answer

Injury to adherent right ventricle

Answer

After prior cardiac surgery, the right ventricle commonly adheres to the posterior table of the sternum, making it vulnerable to laceration during oscillating saw re-entry.

Question 3

Which pharmacologic agent is first-line for treating postoperative vasoplegic syndrome (refractory vasodilation) after cardiac surgery?

Accepted Answer

Vasopressin

Answer

Vasopressin repletes depleted endogenous vasopressin stores and acts on V1 receptors to cause vasoconstriction in catecholamine-refractory vasoplegic syndrome after CPB.

Question 4

What is the preferred surgical approach for repair of an acute Type A aortic dissection in a hemodynamically stable patient?

Accepted Answer

Emergency open repair via median sternotomy

Answer

Acute Type A aortic dissection is a surgical emergency; emergency open replacement of the ascending aorta via sternotomy is the only definitive treatment to prevent rupture and malperfusion.

Question 5

Which intraoperative finding during CABG surgery indicates that a target coronary artery is unsuitable for bypass grafting?

Accepted Answer

Diffuse intramyocardial course

Answer

An intramyocardial (tunneled) coronary artery runs within the myocardium rather than the epicardial surface, making anastomosis technically difficult or impossible and often precluding bypass.

Cardiac Surgery Certification Exam Practice Test

Cardiac Surgery Certification Exam Practice Test

CSC Cardiac Surgery Sample 5