Iraqi Board Thoracic & Cardiovascular Surgery key terms

A length of left or right internal thoracic artery harvested with surrounding tissue, used as a conduit in coronary bypass because its long-term patency exceeds that of vein grafts.

A technique in which blood is diverted from the heart and lungs to an extracorporeal circuit that oxygenates and pumps it, producing a still, bloodless operative field.

A cold or warm solution, often potassium-rich, infused into the coronary circulation to arrest the heart and protect the myocardium during aortic cross-clamping.

A clamp placed across the ascending aorta to isolate the coronary circulation from the bypass circuit, allowing cardioplegia delivery and a motionless operative field.

A tear in the ascending aortic intima that creates a false lumen, a surgical emergency treated by graft replacement of the ascending aorta, often with aortic valve resuspension.

Replacement of the aortic valve, aortic root, and ascending aorta with a composite valve graft, with coronary arteries reimplanted into the graft.

Reconstruction of a regurgitant mitral valve, usually by implanting a prosthetic ring to reshape the annulus, often combined with leaflet or chordal procedures.

Accumulation of fluid in the pericardial sac; when pressure rises enough to impair ventricular filling, it causes tamponade with falling cardiac output and rising central venous pressure.

Needle drainage of pericardial fluid, usually under echocardiographic guidance, used diagnostically or to relieve tamponade.

Thoracic surgery performed through small ports using a camera and instruments, avoiding a large incision and reducing postoperative pain and hospital stay.

Surgical removal of an entire pulmonary lobe, the standard oncologic resection for early-stage lung cancer when the patient can tolerate loss of that lung volume.

Placement, suction settings, and removal criteria for a pleural drain, aiming to evacuate air or fluid and confirm lung re-expansion without air leak.

Air in the pleural space that causes lung collapse; a tension pneumothorax shifts mediastinal structures and requires immediate needle decompression followed by tube drainage.

Deliberate production of pleural inflammation, by talc or mechanical abrasion, to fuse the visceral and parietal pleura and prevent recurrent effusion or pneumothorax.

Fracture of several adjacent ribs in two places, creating a free segment that moves paradoxically with respiration and often signals underlying pulmonary contusion.

Open reduction and internal fixation of fractured ribs with plates and screws, used to stabilize severe chest wall injury, reduce pain, and improve ventilation.

A midline vertical chest incision dividing the sternum, giving wide access to the heart, great vessels, and anterior mediastinum; closure uses wires or plates.

Assessment of mediastinal lymph node involvement in lung cancer, by mediastinoscopy, endobronchial ultrasound-guided biopsy, or imaging, to guide operability and treatment.

Removal of the thymus gland, performed for thymoma or for myasthenia gravis, approached through sternotomy or thoracoscopy.

Resection of part or all of the esophagus, usually with gastric pull-up reconstruction, for cancer or severe motility disease; carries significant leak and pulmonary risk.

Failure of a surgical join to seal, allowing luminal contents to escape; in the chest it can cause mediastinitis, empyema, and sepsis and may need reoperation or drainage.

Postoperative accumulation of blood or clot in the pericardium that compresses the heart, causing hypotension, rising filling pressures, and low urine output; requires urgent drainage.

Prolonged extracorporeal support that oxygenates and removes carbon dioxide from blood, used for reversible cardiac or respiratory failure when other support fails.

An implanted pump that draws blood from the left ventricle and delivers it to the aorta, used as bridge or destination therapy for advanced heart failure.

Administration of protamine sulfate to neutralize heparin after cardiopulmonary bypass, restoring clotting; excess can cause hypotension or paradoxical bleeding.

Ultrasound imaging of the heart and thoracic aorta from a probe in the esophagus, used intraoperatively to assess valves, ventricular function, and aortic pathology.

Ultrasound imaging of the heart through the chest wall, used to measure ejection fraction, valve function, and pericardial fluid at the bedside.

X-ray imaging of coronary arteries after contrast injection through a catheter, defining the location and severity of stenoses before revascularization.

Catheter-based treatment of coronary stenosis by balloon dilation and stent placement, an alternative or adjunct to bypass surgery depending on anatomy and risk.

The ratio of pressure distal to a coronary stenosis to aortic pressure during maximal hyperemia; values at or below 0.80 indicate a lesion worth revascularizing.

The relationship between coronary blood flow delivering oxygen and the heart's metabolic need; imbalance from stenosis, hypertrophy, or tachycardia causes ischemia.

The principle that increased ventricular filling raises stroke volume up to a point, after which overdistension reduces effective contraction; central to fluid management.

Use of aspirin, often with a P2Y12 inhibitor, to prevent graft thrombosis after coronary surgery, balanced against bleeding risk.

Judging a trial by randomization quality, allocation concealment, blinding, completeness of follow-up, and effect size, to decide whether its result should change practice.

The number of patients who must receive an intervention for one additional patient to benefit, calculated as the reciprocal of the absolute risk reduction.

The process of explaining diagnosis, proposed operation, alternatives, and material risks in understandable terms, confirming the patient's voluntary agreement before operating.

A structured verbal checklist completed before induction, before incision, and before leaving the operating room to confirm patient identity, procedure, and equipment readiness.