Cardiac Surgery : The Denervated Heart

Heart failure affects nearly 6 million Americans. It is the leading cause of hospitalization in people older than 65. Roughly 550,000 people are diagnosed with heart failure each year (Emory Healthcare, 2014). Heart failure is a pathologic state where the heart cannot pump enough blood to meet the demand of the body’s metabolic needs or when the ventricle’s ability to fill is impaired. It is not a disease, but rather a complex clinical syndrome. The symptoms of heart failure come from pulmonary vascular congestion and inadequate perfusion of the systemic circulation. Individuals experience orthopnea,

The Cardiovascular system – The left ventricle undergoes remodelling consisting of left ventricular dilation and hypertrophy (enlargement), such that stroke volume is increased without an actual increase in the ejection fraction. Cardiac changes that occur following heart failure are:      Decreased stroke volume and cardiac output Increased end diastolic pressure Ventricular dilation or hypertrophy (enlargement) Impaired filling (diastolic dysfunction) Reduced ejection fraction (systolic function)

However, in the further with further increasing numbers of SV survivors, we will probably encounter CADs in SV patients. Nevertheless and more importantly, in SV patients who have received or will receive heart transplant an previously had IMAs embolization, IMAs CABG would not be available for them when they develop transplant coronary arterial (allograft) vasculopathy. Transplant coronary arterial (allograft) vasculopathy is of the foremost causes of morbidity and mortality after heart transplantation. Surgical (CABG) and transcatheter revascularization has been reported as a successful and viable treatment options in short as well as midterm follow up [26,27]. Therefore, losing IMAs will deprive those patients from the best graft to treat their

The need for a heart transplant can be outlined to one of many heart difficulties, each of which causes harm to the heart muscle. The two most frequent heart difficulties are coronary artery disease and idiopathic cardiomyopathy. Coronary artery disease develops when your coronary arteries ( a the key blood vessels) become damaged or diseased. Cholesterol (plaque) containing deposits in your arteries and inflammation are usually to blame for coronary artery disease. Dilated idiopathic cardiomyopathy occurs when heart muscle stretches and thins without any obvious cause. Thinning and widening of the heart muscle means that the chambers of the heart become bigger. Over time, the

It is important to recognize the severity of heart disease in both the generic and acquired forms. A typical adult heart has approximately five billion heart cells, all pulsing in sync with every heartbeat. These cells can be de destroyed with many different health conditions like; high blood pressure, blood clots, heart attacks, and other cardiovascular disease. As we age it is evident that out heart is also aging, which age in mind after the first half of our lives cells which have been damaged are unable to replace them selves. Heart failure occurs when the myocardium is unable to meet the body’s metabolic demands. Unlike some organs, the heart has limited, if any, capacity for repair after injury. Heart transplantation remains

A heart transplant is surgery to remove a damaged or diseased heart and replace it with a healthy donor heart. Finding a donor heart can be difficult. The heart must be donated by someone who is brain-dead but is still on life support. The donor heart must be matched as closely as possible to your tissue type to reduce the chance that your body will reject it. You are put into a deep sleep with general anesthesia, and a cut is made through the breastbone

The Circulatory system is responsible for the transport and delivery of essential nutrients and molecules required for proper cellular function including oxygen, proteins, and much more (Silverthorn, 2013). The circulatory system also carries waste products to be excreted by the body by other systems such as the urinary and respiratory system (Silverthorn, 2013). The main organ in the circulatory system is the heart which will be concentrated on within this paper in order to understand how the normal physiology of the heart relates to the pathophysiology of congestive heart failure,

Hypertrophic cardiomyopathy can be specifically treated with beta-blockers and calcium antagonists (Dechant, 2016). The patient, however, is not on any of these medications at this time due to his condition after surgery and the fact that he is NPO. As for home medications, the patient’s chart says that he stated that he does not take any home medications, meaning he does not take medications to treat his cardiomyopathy. Surgical procedures to treat cardiomyopathy include ventriculomyomectomy, which includes the removal of part of the ventricular septum to further open the thickened ventricles in hypertrophic cardiomyopathy (Dechant, 2016). A heart transplant can help with dilatated and restrictive cardiomyopathy by replacing the damaged heart with a normal one (Dechant, 2016). The patient has not had any surgical procedures to treat his

The term “ventricular remodelling” includes a complex of anatomic, functional, cellular, and molecular changes in the myocardium in response to the injury Markers of cardiac remodelling are hemodynamic and echocardiographic changes which correlate with cardiac impairment (Cohn et al., 2000; Kubanek et al., 2013). In HF animal models, the process of left ventricular (LV) remodelling begins rapidly, and continues to progress; LV are a greater cardiac chamber dilation, a greater increase in systolic and diastolic volume index and a progressive decline in the ejection fraction (EF) (Eaton et al., 1981; Korup et al., 1997; Cohn et al., 2000; Kubanek et al., 2013).

The article, “Prevalence and Predictors of Early Cardiovascular Events after Kidney Transplantation: Evaluation of Pre-Transplant Cardiovascular Work-Up” mentions how cardiovascular disease is the leading factor of deaths after a renal transplantation. Therefore, in order to prove their hypothesis correct a study was created to analyze if cardiovascular risk factors are developed after transplantation. The study includes first year patients who have had a renal transplantation. In addition, a pre-transplant work-up will be conducted in order to show if any type of disorders will be present beforehand. The following essay is a summary of the article, “Prevalence and Predictors of Early Cardiovascular Events after Kidney Transplantation: Evaluation of Pre-Transplant Cardiovascular Work-Up”.

Dr. Volk had several different heart issues that resulted in his eventual heart transplant. One of the issues was called dilated cardiomyopathy, or the enlargement of chambers of the heart that typically starts with the enlargement of the left ventricle (American Heart Association, 2016). When a heart is enlarged too much the cardiac muscles can’t work as efficiently resulting in weaker contractions. Since his left ventricle was enlarged he was unable to pump a sufficient amount of blood to his body (American Heart Association, 2016). This resulted in Dr. Volk’s body not getting sufficient oxygen or nutrients. When blood enters a normal sized heart the cardiac muscles are stretched to an ideal length based on the length-tension relationship

Before the invention of the pacemaker and other technologies, scientists and doctors alike were concerned with understanding one of the most complex organs in the human body, the heart. By the 1900s, open-heart surgery was quickly becoming one of the most rapidly growing fields for upcoming surgeons. Even though surgeons were able to perform open-heart surgeries on those who needed it, what was supposed to happen to those whose hearts were failing completely? Fortunately, the aspirations of one doctor would provide an answer to that question in the form of an unthinkable surgical procedure. The name of that doctor was Christiaan Neethling Barnard.

On Tuesday, my assignment was in OR 11. In this room, cardiothoracic surgeries are performed. The surgery schedule was a segmentectomy of the lower lobe of the left lung. During this case I was able to put into practice different techniques learned in the labs, such as how to insert a Foley catheter. With the help of the circulator, I cleaned the perineal area and placed the catheter using sterile techniques. Since the surgery was performed on the left side, the patient was accommodated into a lateral positioning. The circulator nurse and I put sponges around the bony prominence to prevent skin breakdowns, and nerve and ligaments teardowns. Once the surgery started, the surgeon took different specimens from different parts of the left lower

“Myocardial infarction occurs when myocardial tissue is abruptly and severely deprived of oxygen. When blood flow is quickly reduced by 80% to 90%, ischemia develops. Ischemia can lead to injury and necrosis of myocardial tissue if blood flow is not restored” (Ignativicus & Workman, 2013, p 829). When the heart is hypoxic, the vessels vasodilate and catecholamines are released, in an effort to carry more hemoglobin rich red blood cells to the site of infarction. These protective mechanisms actually increase the oxygen demand of the heart by increasing the workload and cause further hypoxia of the myocardial tissues. In as little as six hours, ischemic myocardial tissue, necrotic tissue, and ventricular remodeling can occur. Ventricular remodeling is a permanent effect on the heart that can occur if the infarction is not treated quickly enough. Scar tissue forms in the left ventricle which affects its functionality. This condition is associated with a high risk of chronic

Coronary artery bypass grafting (CABG) is a surgical procedure performed on patients with coronary artery disease to improve their survival and quality of life. (1) It remains to be the gold standard treatment for patients requiring multivessel coronary revascularization despite recent advances in medical therapies and Percutaneous Coronary Intervention (PCI). (2) There are two forms of CABG. Traditionally, CABG is performed with a cardiopulmonary bypass (CPB) machine (aka heart lung machine or “the pump”) which maintains circulation while the heart is temporarily stopped. (1) This creates a bloodless and motionless operating field for the surgeons. (3) The body is then weaned from CPB and the heart is restarted with the completion of grafting. (1) Alternatively, a relatively newer technique called off-pump CABG or beating heart surgery can be performed. With this procedure, CPB is not utilized and the surgeon grafts the blood vessel on the pumping heart after the area around the blocked coronary artery is stabilized. (1)