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Cardiac Surgery   Wejdan Khater, RN, PhD  NUR 415- Spring 2008 Jordan University of science and technology
Cardiac Management ,[object Object]
Percutaneous Transluminal  Coronary Angioplasty ,[object Object],[object Object],[object Object]
Percutaneous Transluminal  Coronary Angioplasty  [PTCA] ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Percutaneous Transluminal  Coronary Angioplasty  [PTCA] ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Percutaneous Transluminal  Coronary Angioplasty  [PTCA] ,[object Object],[object Object],[object Object]
PTCA
 
 
 
 
GOALS OF PTCA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pre-procedure preparations  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pre-Procedure Preparations  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pre-Procedure Preparations  ,[object Object],[object Object],[object Object],[object Object],[object Object]
PTCA -Intra procedure  ,[object Object],[object Object],[object Object],[object Object]
PTCA -Intra procedure  ,[object Object]
PTCA –post procedure  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PTCA –post procedure  ,[object Object],[object Object],[object Object],[object Object],[object Object]
COMPLICATIONS PTCA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
OTHER INTERVENTIONAL CARDIAC PROCEDURES ,[object Object],[object Object]
CURRENT INTERVENTIONAL CARDIAC PROCEDURES ,[object Object],[object Object]
Stent
Stent
Coronary Artery Revascularization Bypass:  CABG Procedure   CANDIDATES  FOR CABG PRE-OP, INTRA -OP,  & POST-OP CARE COMPLICATIONS
What is Open Heart Surgery?  It isn’t just CABG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
WHAT IS CABG ,[object Object]
WHAT IS CABG ,[object Object],[object Object],[object Object],[object Object]
WHO NEEDS CABG??  CONDITIONS THAT NEED CORONARY REVASCULARIZATION : ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
WHO NEEDS CABG??  CONDITIONS THAT NEED CORONARY REVASCULARIZATION : ,[object Object],[object Object]
AHA/AC AHA/ACC Definition of Classes for Various Conditions C Definition of C  AHA/ACC Definition of Classes for Various Conditions ,[object Object],[object Object],[object Object],[object Object],[object Object]
ACC/AHA Guidelines for Coronary Artery Bypass Graft Surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
EMERGENCY VS ELECTIVE CABG ,[object Object],[object Object],[object Object]
RISK FACTORS FOR CABG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CABG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pre-operative  ,[object Object],[object Object],[object Object],[object Object],[object Object]
PRE-OP NURSING CARE ,[object Object],[object Object],[object Object],[object Object],[object Object]
PRE-OP NURSING CARE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TEACHING NEEDS OF THE “REDO” ,[object Object],[object Object]
INTRA-OPERATIVE CARE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vessel Patency ,[object Object],[object Object],[object Object],[object Object]
LIMA is the most commonly used Arterial graft, most commonly grafted  W/ LAD, 90-95% 10 yr patency   10 yr patency for vein grafts is 50%
CABG
Cardiopulmonary Bypass ,[object Object],[object Object]
Cardiopulmonary Bypass
Cardiopulmonary Bypass ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Overview of CABG procedure Skin  incision Expose breast bone Divide breast bone Retractor placed
Overview of CABG procedure pericardiotomy Heart visualized Aortic cannula brings blood  from CPB to aorta Venous cannula drains blood From heart to CPB
Overview of CABG procedure Cardioplegia tube inserted In aorta Cardioplegia tube In coronary sinus
Overview of CABG procedure Heart stopped, aortic clamp Placed, no flow in heart Bypass vessel grafted Clamp removed,  Cardioplegia reversed Heart beating normally, CPB stopped
Overview of CABG procedure Chest tubes placed Sternum closed w/ Metal wire Skin closed Sterile bandage applied
Overview of CABG procedure
NURSING DIAGNOSIS   INTRAOPERATIVELY FOR CABG ,[object Object],[object Object],[object Object],[object Object],[object Object]
POST-OP NURSING CARE FOR CABG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
POST-OP NURSING CARE FOR CABG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Pathways ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Initial Priorities cont. ,[object Object],[object Object],[object Object],[object Object],[object Object]
Collaborative Management ,[object Object],[object Object],[object Object],[object Object],[object Object]
Initial Priorities cont. ,[object Object],[object Object],[object Object],[object Object]
Priorities of Care ,[object Object],[object Object],[object Object],[object Object],[object Object]
COMPLICATIONS OF CABG :  Early PO Period ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications :  Hypothermia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications :  Bleeding ,[object Object],[object Object],[object Object],[object Object]
Complications  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications of CABG:  Late Postoperative Period ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Complications of CABG ,[object Object]
Prevention of CABG Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prevention of CABG Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prevention of CABG Complications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prevention of CABG Complications ,[object Object],[object Object],[object Object],[object Object]
Nursing Diagnosis ,[object Object],[object Object],[object Object]
Nursing Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Nursing Diagnosis ,[object Object],[object Object],[object Object]
Nursing Diagnosis ,[object Object],[object Object],[object Object]
HEART TRANSPLANTATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IABP ,[object Object],[object Object],[object Object]
IABP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IABP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IABP
IABP ,[object Object],[object Object],[object Object]
IAPB
IABP ,[object Object],[object Object]
IABP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IABP ,[object Object],[object Object],[object Object],[object Object],[object Object]
Weaning of IABP/ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IABP/complications  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
IABP/Complications
IABP Removal ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Cardiac surgery and ptca

  • 1. Cardiac Surgery Wejdan Khater, RN, PhD NUR 415- Spring 2008 Jordan University of science and technology
  • 2.
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  • 19.
  • 20.
  • 21.
  • 22.
  • 23. Stent
  • 24. Stent
  • 25. Coronary Artery Revascularization Bypass: CABG Procedure CANDIDATES FOR CABG PRE-OP, INTRA -OP, & POST-OP CARE COMPLICATIONS
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
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  • 32.
  • 33.
  • 34.
  • 35.
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  • 38.
  • 39.
  • 40.
  • 41.
  • 42. LIMA is the most commonly used Arterial graft, most commonly grafted W/ LAD, 90-95% 10 yr patency 10 yr patency for vein grafts is 50%
  • 43. CABG
  • 44.
  • 46.
  • 47. Overview of CABG procedure Skin incision Expose breast bone Divide breast bone Retractor placed
  • 48. Overview of CABG procedure pericardiotomy Heart visualized Aortic cannula brings blood from CPB to aorta Venous cannula drains blood From heart to CPB
  • 49. Overview of CABG procedure Cardioplegia tube inserted In aorta Cardioplegia tube In coronary sinus
  • 50. Overview of CABG procedure Heart stopped, aortic clamp Placed, no flow in heart Bypass vessel grafted Clamp removed, Cardioplegia reversed Heart beating normally, CPB stopped
  • 51. Overview of CABG procedure Chest tubes placed Sternum closed w/ Metal wire Skin closed Sterile bandage applied
  • 52. Overview of CABG procedure
  • 53.
  • 54.
  • 55.
  • 56.
  • 57.
  • 58.
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  • 72.
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  • 74.
  • 75.
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  • 77.
  • 78.
  • 79. IABP
  • 80.
  • 81. IAPB
  • 82.
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  • 88.