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Anesthesia for Cardiac Surgery Part 1 Terms in this set (179) How is coronary perfusion pressure calculated? (Aortic DBP - LVEDP)/coronary vascular resistance What is the most useful indicator of CoPP? MAP Under normal conditions, what MAP is CoPP autore $8.99   Add to cart

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Anesthesia for Cardiac Surgery Part 1 Terms in this set (179) How is coronary perfusion pressure calculated? (Aortic DBP - LVEDP)/coronary vascular resistance What is the most useful indicator of CoPP? MAP Under normal conditions, what MAP is CoPP autore

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Anesthesia for Cardiac Surgery Part 1 Terms in this set (179) How is coronary perfusion pressure calculated? (Aortic DBP - LVEDP)/coronary vascular resistance What is the most useful indicator of CoPP? MAP Under normal conditions, what MAP is CoPP autoregulated between? MAP 60 - 110 How do...

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  • August 10, 2024
  • 10
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • CGAP - Certified Government Auditing Professional
  • CGAP - Certified Government Auditing Professional
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Denyss
8/10/24, 6:08 AM



Anesthesia for Cardiac Surgery Part 1
Jeremiah
Terms in this set (179)

How is coronary perfusion pressure (Aortic DBP - LVEDP)/coronary vascular resistance
calculated?

What is the most useful indicator of CoPP? MAP

Under normal conditions, what MAP is CoPP MAP 60 - 110
autoregulated between?

Flow is no longer autoregulated after it passes the partial obstruction
How does CAD affect CoPP?
CoPP becomes pressure dependent, especially when MAP <70

Perfusion pressure gradient


Time allotted for flow
What is total coronary blood flow
determined by with CAD?
Coronary anatomy


Coronary vascular resistance

Which region of the heart is at most risk for Subendocardium = exposed to the highest LVEDP
ischemia with CAD?

What two factors decrease myocardial Tachycardia
blood supply and increase myocardial
oxygen demand? Increases in LVEDP

What is the most significant cause of Tachycardia
perioperative ischemia?

What is tachycardia an independent Cardiac & all-cause mortality in men and women with and without CAD
predictor of?

Maintain adequate MAP
What is the goal in improving myocardial
oxygen supply & demand?
Avoid tachycardia




1/10

, 8/10/24, 6:08 AM
Eccentric
Dilated
Systolic dysfunction
What is the difference between eccentric
and concentric hypertrophy?
Concentric
Thickening
Diastolic dysfunction



What are factors that affect myocardial
supply and/or demand?



In the subendocardium, autoregulation is exhausted
and flow becomes pressure-dependent when
pressure distal to a stenosis declines to less than 70
mmHg
How does autoregulation differ between the
subendocardium and subepicardium? In the subepicardium, autoregulation persists until
perfusion pressure declines to <40 mmHg


Autoregulatory coronary reserve is less in the
subendocardium

The RV is perfused throughout the cardiac cycle
How does blood flow differ between the
right and left coronary artery? Flow to the LV is largely confined to diastole



Tachycardia (decreased diastolic time)


Hypotension

What are common causes of decreased O2
Increased pulmonary artery EDP
supply?

Decreased O2 content


Anemia

Keep HR relatively low (<70 bpm)
What is the perioperative management
strategy for tachycardia?
Deepen anesthesia during stimulating periods

Maintain high normal MAP


What is the perioperative management Consider phenylephrine
strategy for hypotension?
Decrease anesthetic depth during less stimulating periods and surgical manipulation
that causes decreased MAP

Consider NTG
What is the perioperative management
strategy for increased PaEDP?? Evaluate LV volume with TEE (PaEDP increased in patients with concentric LVH &
increased LVEDV)

What is the perioperative management Maintain SaO2 >95%
strategy for decreased O2 content?
What is the perioperative management Maintain adequate hemoglobin

strategy for anemia?
Anesthesia for Cardiac Surgery Part 1

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