ABTS Thoracic Surgery flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Left main CABG threshold

CABG is generally indicated for left main coronary artery stenosis of at least 50%, especially when anatomy is suitable, because it improves survival compared with medical therapy alone.

Severe aortic stenosis criteria

Severe aortic stenosis is defined by aortic valve area of 1.0 cm² or less, mean gradient of 40 mm Hg or more, or peak velocity of 4.0 m/s or more.

Stanford type A dissection

Stanford type A aortic dissection involves the ascending aorta and is a surgical emergency; type B spares the ascending aorta and is usually managed medically unless complicated.

Full heparinization ACT target

For cardiopulmonary bypass, full heparinization is monitored by activated clotting time, with a common target range of 400 to 480 seconds before initiating bypass.

Protamine reversal dose

Protamine reverses heparin after cardiac surgery, commonly dosed at about 1 mg per 100 units of heparin given, with adjustment for total heparin dose and bleeding.

Primary mitral regurgitation surgery trigger

Surgery is indicated for symptomatic severe primary mitral regurgitation or asymptomatic severe regurgitation with left ventricular ejection fraction of 60% or less or left ventricular end-systolic dimension of 40 mm or more.

Mechanical versus bioprosthetic valve

Mechanical aortic valves are generally chosen for younger patients because of durability, while bioprosthetic valves are preferred for older patients or those who cannot safely take long-term anticoagulation.

Post-CABG aspirin timing

After coronary artery bypass grafting, aspirin is typically started within 6 hours when there is no active bleeding, because early antiplatelet therapy reduces graft thrombosis and adverse cardiac events.

del Nido cardioplegia

del Nido cardioplegia is a single-dose crystalloid blood cardioplegia solution used for myocardial protection, often allowing longer intervals between doses during adult cardiac operations.

Aortic cross-clamp purpose

An aortic cross-clamp isolates the coronary circulation from the systemic circulation, allowing cardioplegia delivery and a bloodless field for aortic valve, root, or coronary anastomotic surgery.

EuroSCORE II

EuroSCORE II estimates in-hospital mortality after adult cardiac surgery using patient, cardiac, and operative variables; it supports risk discussion but does not replace clinical judgment.

Post-cardiac surgery atrial fibrillation

Atrial fibrillation is common after cardiac surgery and is associated with stroke, prolonged stay, and hemodynamic instability; rate or rhythm control is used with anticoagulation considered according to stroke risk.

T1 lung cancer size

In the eighth edition TNM staging, T1 lung cancer is 3 cm or less in greatest dimension, subdivided into T1a up to 1 cm, T1b over 1 to 2 cm, and T1c over 2 to 3 cm.

N2 lung cancer

N2 lung cancer means metastasis to ipsilateral mediastinal or subcarinal lymph nodes; it is distinct from N1 hilar or peribronchial nodes and N3 contralateral or supraclavicular nodes.

Stage I NSCLC surgery

For medically operable stage I non-small cell lung cancer, lobectomy with lymph node sampling is the standard; stereotactic body radiation therapy is used when surgery is contraindicated or refused.

Sublobar resection indication

Sublobar resection, such as segmentectomy or wedge resection, may be acceptable for peripheral non-small cell lung cancers of 2 cm or less with ground-glass features, especially when lung function is limited.

Malignant pleural effusion management

Recurrent symptomatic malignant pleural effusion is managed with indwelling pleural catheter or pleurodesis after confirmed diagnosis, with thoracentesis used for initial relief and cytologic evaluation.

Primary spontaneous pneumothorax

A small primary spontaneous pneumothorax without dyspnea may be observed, while a large or symptomatic pneumothorax requires needle decompression when unstable and then tube thoracostomy.

Esophageal cancer neoadjuvant therapy

Locally advanced esophageal cancer, especially T2 to T4 or node-positive disease, is commonly treated with neoadjuvant chemoradiation followed by esophagectomy to improve survival.

Thymoma myasthenia association

Thymoma is associated with myasthenia gravis in a substantial minority of patients; resectable thymoma is treated with complete surgical resection, and biopsy is avoided when resection is planned.

Predicted postoperative FEV1

Predicted postoperative FEV1 estimates remaining lung function after resection; values below 30% of predicted, especially with low DLCO, identify patients at high risk for perioperative complications.

Chest tube air leak

A persistent air leak after lung resection is commonly defined as an air leak lasting more than 5 days; management includes observation, suction adjustment, and occasionally pleurodesis or reoperation.

Large VSD pathophysiology

A large ventricular septal defect causes left-to-right shunting, pulmonary overcirculation, and heart failure in infancy; unrepaired disease can lead to pulmonary vascular disease and Eisenmenger syndrome.

Tetralogy of Fallot features

Tetralogy of Fallot consists of ventricular septal defect, pulmonary stenosis, overriding aorta, and right ventricular hypertrophy; cyanosis depends on the degree of right ventricular outflow obstruction.

Transposition of great arteries

Transposition of the great arteries is ventriculoarterial discordance with parallel circulations; survival depends on mixing through an atrial septal defect, ventricular septal defect, or patent ductus arteriosus.

Coarctation repair threshold

Coarctation repair is generally indicated for a peak systolic gradient of 20 mm Hg or more, or for significant upper-extremity hypertension, with associated bicuspid aortic valve common.

Fontan circulation

Fontan palliation directs systemic venous return to the pulmonary arteries without a subpulmonary ventricle; late complications include arrhythmia, protein-losing enteropathy, plastic bronchitis, and liver dysfunction.

Preterm PDA closure

In preterm infants, a hemodynamically significant patent ductus arteriosus may be closed with cyclooxygenase inhibitors such as indomethacin or ibuprofen, or by surgical ligation when drug therapy fails or is contraindicated.

Eisenmenger syndrome

Eisenmenger syndrome is pulmonary vascular disease with reversed or bidirectional shunting from an unrepaired left-to-right shunt; shunt closure is contraindicated, and management focuses on pulmonary vasodilators and supportive care.

ASD closure indication

Atrial septal defect closure is indicated when there is a significant left-to-right shunt, typically pulmonary-to-systemic flow ratio above 1.5, or right ventricular enlargement, provided pulmonary vascular resistance is not severely elevated.

Critical neonatal aortic stenosis

Critical neonatal aortic stenosis presents with ductal-dependent systemic blood flow and severe heart failure; initial management includes prostaglandin E1 and balloon aortic valvotomy or surgical valvotomy.

Bicuspid aortic valve

Bicuspid aortic valve is the most common congenital cardiac anomaly and is associated with aortic stenosis, aortic regurgitation, coarctation, and aortopathy requiring surveillance of aortic root and ascending aortic dimensions.