glossary of heart surgery

8/3/2019 Glossary of Heart Surgery

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GLOSSARY OF TERMS AND ACRONYM EXPANSIONS FOR

PERFUSION TECHNOLOGY, OPEN HEART SURGERY AND

CARDIOLOGY

The following list of perfusion technology terms is offered as a service to

the community by the Cardiovascular Perfusion Education Program &

Life Support Departments of the Medical University of South Carolina.

If you do not find the term or acronym that you are looking for, or perhaps

you disagree with a definition or have coined a new term or acronym,

please contactJeffrey R. Acsell CCPwith your request to include a term

or abbreviation in this glossary, or for further information on a term, leave

your e-mail address and you will be contacted.

Select the beginning alphabet character to search:

ABCDEFGHIJKLMNOPQRSTUVWXYZ

Other Glossary Links

[ ]:

Symbol for concentration, usually expressed as moles per liter (M/l). [H+] =

Hydrogen ion concentration

A

a-:

away from, opposite

AAA (triple A):

abdominal aortic aneurysm

AACP:

American Academy of CardiovascularPerfusion

A-aDO2:

alveolar arterial oxygen gradient

ABCP:American Board of CardiovascularPerfusion; the national body regulating and

managing certification (CCP) of perfusion technologists

abd.:

abdomen

ABG:

arterial blood gas, a collection ofpO2, pCO2,pH, BEandHBSaO2

measurements from an arterial blood sample

ABO blood group system:

the most important of several systems for classifying human blood used in

transfusion therapy

ACE:angiotensin-converting enzyme
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acid:

A substance which can donate H+. Large amounts are produced in the body as

a by product of metabolism and to aid digestion. H2CO3 is a volatile acid that

can be removed from the body as CO2 by the lungs. Nonvolatile acids such as

lactic acid are produced in small amounts by metabolism and are removed by

the kidneys. (the lungs excrete approximately 13,000 mEq of H2CO3 in theform of CO2 per day, the kidneys eliminate 50 - 100 mEq of nonvolatile acids

per day) Excess acids are harmful to the body because they increase the [H+]

which interferes with the bodys normal cellular and chemical function.

acid-base balance:

the maintanence of a normal level of acid and base in the blood and plasma

acidemia:

abnormally high level of acid in the blood, low pH (< 7.35)

acidosis:

a pathologic condition resulting from accumulation of acid in, or loss of base

from the body

ACLS:Advanced Cardiac Life Support

ACT:

activated clotting time

ACTH:

adrenocorticotropic hormone

acute myocardial infarction:

an acute process ofmyocardialischemiawith sufficient severity and duration

to result in permanent myocardial damage

ADP:

adenosine diphosphate

adventitia:

the outside coat of a tissue or structure (see t. adventitia)

AF bypass:

aortofemoral bypass

affinity:

the force of attraction holding two elements together, such as hemoglobin

affinity for oxygen

A Fib:

atrial fibrillation

A Flt:

atrial flutteragglutination:

the process of blood cells clumping together as result of antibody interactions

AI:

aorticinsufficiency: aortic valvular incompetence: failure of the aortic valveto

close during diastole causing back flow into the left ventricle

AICD:

automatic internal cardioverter/defibrillator

AIDS :

acquired immune deficiency syndrome; a serious, fatal condition in which the

immune system is broken down by the HIV virus and does not respond

normally to infectionsAIVR:
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accelerated idioventricular rhythm

A-line:

arterial line

alkalemia:

an arterial blood pH above normal (> 7.45) due to abnormally high base to

acid ratio in the bloodalkalosis:

a pathologic condition resulting from accumulation ofbase in, or loss of acid

from the body

allograft:

tissue graft from animal of the same species, not same genotype

alpha stat:

ventilation scheme where the total CO2 remains constant as temperature falls

and the non-temperature corrected ABG appears normal. So called because it

keeps the alpha imidazole moiety of histadine in the alpha charge state. This

promotes respiratory alkalosis (about 0.01465 pH units peroC rise;Rosenthal

Correction Factor) in the CPB blood.ALT:

see SGPT

alveoli:

the small, sac-like structural unit of the lung where oxygen is exchanged for

carbon dioxide

AMP:

adenosine monophosphate

AmSECT:

American Society ofExtra-CorporealTechnology; the largest professional

organization representingperfusion technologists

anaphylactic shock:

a severe hypersensitivity reaction to the injection or ingestion of a substance to

which the organism has been previously exposed

ancrod:

anticoagulant derived from Malayan pit viper venom, depletes fibrinogen

aneurysm:

the abnormal dilation or out-pouching of a blood vessel or ventricle

anginapectoris:

a clinical syndrome typically characterized by a deep, poorly localized chest or

arm discomfort that is reproducibly associated with physical exertion or

emotional stress and relieved promptly by rest or sublingual NTG.angiographically significant CAD:

CAD is typically judged "significant" at coronary angiography if there is at

least a 70 percent diameter stenosis of one or more major epicardial coronary

segments or at least a 50 percent diameter stenosis of the left main coronary

artery

antegrade:

with the normal direction of flow

anti-:

against, or opposed to

antibody :

a complex molecule produced by specialized cells in response to the presenceof an antigen
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anticoagulant:

any agent that inhibits coagulation , see; heparin, ancrod,hirudin

antigen:

any substance percieved as foreign by the body that induces antibody

production

anxiolytic therapy:treatment to counteract or diminish anxiety

A&Ox3:

alert and oriented to person place and time

aorta:

the large single artery arising from the left ventricle carrying blood to the

systemic circulation

aortic:

of or pertaining to the aorta

aortic atresia :

small or undeveloped aortic valve

aortic valve:the semilunar valve separating the left ventricle from the aorta that prevents

backflow of blood into the ventricle

aortotomy :

a surgical incision into the aorta

apheresis:

the separation or removal of a blood component or chemical to treat a disease

or condition

aPPT:

activated partial thromboplastin time

AR:

aortic regurgitation, aortic insufficiency (AI)

ARDS:

adult respiratory distress syndrome; a disease process where the patient's lung

fail to remove sufficient carbon dioxideand provide sufficient oxygen during

ventilation

ARF:

acute renal failure

arrhythmia:

irregularity or loss of rhythm of the heartbeat

ART:

arterialarteriole:

a small artery branching off of an artery giving rise to thecapillary network

arteriosclerosis:

the process thickening and loss of elasticity in the walls of arteries

artery:

a blood vessel that carries blood away from the heart; arteries usually carry

oxygenated blood

AS:

aortic valvularstenosis:narrowing of the normal aortic valve area causing a

pressure drop across the aortic valve during ventricularsystole

ASA:aspirin
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ASD:

atrial septal defect,

ASCVP:

Australasian Society of Cardiovascular Perfusionists, represents all

perfusionists in Australia and New Zealand

ASPVD:atherosclerotic peripheral vascular disease

AST:

see SGOT

ASV:

autogenous saphenous vein

ATIII:

antithrombin III, an albumin cofactor that normally binds free thrombin in the

blood, heparin catalyzes the anti-thrombin action of ATIII 1000 times normal

atherosclerosis:

a form ofarteriosclerosisin which atheromas containing cholesterol, lipoid

material and lipophages are formed within the intima and innermediaof largeand medium-sized arteries

ATN:

acute tubularnecrosis:ischemic damage to the tubule cells of the kidney

causing renal failure

ATP:

adenosine triphosphate

atrial:

of or referring to the atrium or atria

atrialization:

appearing or becoming atrial like

atrium:

a chamber affording entrance to another structure or organ;

r. atrium the upper right cardiac chamber that receives blood from the venae

cavae and delivers blood to the rightventricle

l. atrium the upper left cardiac chamber that receives blood from the

pulmonary veins and delivers blood to the left ventricle (pleural form is atria)

ATS:

autotransfusion system; an extracorporeal circuit designed to collect a patient's

shed blood during a surgical procedure and reinfuse the blood back to the

patient; blood may be collected by pre-donation, intraoperative salvage or post

operative wound drainageautograft:

tissue graft from self

autologous:

referring to self, or tissue coming from the self

autoregulation:

the ability of an organ system to dilate or constrict the arteriols that enter it in

order to control the blood flow to the organ to meet it's metabolic needs

AV:

1. atrioventricular;

2. aortic valve;

3. arterio venousAVA:
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aortic valve area

AVB:

atrio-ventricular block

AV canal:

atrioventricular canal

AV node:atrioventricular node

AVG:

aortic valve gradient

AVR:

aortic valve replacement; open heart surgery to replace a diseased aortic valve

with a prosthetic, artificial valve

B

base:

a substance capable of accepting or binding a hydrogen ion (H+) in a chemical

reaction; The bicarbonate ion [HCO3-] is the most important base in the body.

base excess (BE):

a measurement of the total acid base ratio; the difference between the actual

blood buffer concentration and the normal blood buffer concentration, reflects

mainly the [HCO3-] in the plasma compaired with the expected [HCO3

-].

BB:

bloodbuffer, the sum of all of theplasma andRBC blood buffer systems:

bicarbonate, hemoglobin, phosphate and proteins that serve to prevent changes

in the pH of the bloodBBB:

bundle branch block

beta blocker (beta-adrenergic blocking agent):

a drug that blocks the effect ofcatecholamines, producing a decrease in heart

rate and oxygen demand in themyocardium

bicarbonate [HCO3-]:

the most common base found in theplasmaand RBC

BiVAD:

bi-ventricular assist device; the use of two blood propulsion devices or ECCs

to assist the failing right and left ventricles

blood volume:the amount of blood circulating throughout the body in thevascularsystem

Blood Gas (ABG):

Laboratory test that usually includes the pH, pO2, pCO2, Total CO2, HCO3-,

BE, Hb Saturation, HCT, and possibly the K+, Ca++, and Glucose.

Normal Adult Values:

Source HWD ZWD MUSC Lab

pH arterial 7.35-7.45 7.38-7.42 7.350-7.450

venous 7.320-7.420

pCO2 arterial 35-48(mmHg) 38-42(mmHg) 35-45(mmHg)
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venous 41-51(mmHg)

pO2 arterial 80-100(mmHg)

venous 25-40(mmHg)

[HCO3- 23-28(mEq/L) 22-26(mEq/L) 22-26(mEq/L)

[K+] serum 3.4-5.3(mEq/L)

[Na+] serum 136-146(mEq/L)

[Cl-] serum 95-105(mEq/L)

Horace W. Davenport, The ABC of Acid-Base Chemistry (sixth edition) TheUniversity of Chicago Press 1974

Zagelbaum, Welch, Doyle.Basic Arterial Blood Gas Interpretation. LittleBrown and Company 1988

BLS:

basic life support

BMR:

basal metabolic rate

bohr effect:

the influence of carbon dioxide on the affinity ofhemoglobinto bind with

oxygen, increasing the carbon dioxide level decreases the affinity of

hemoglobin for oxygen

BPG:bypass graft

BPM:

beats per minute

bronchioles / bronchi:

the tubes or airways for the lungs that lead from the trachea to the alveoli

BSA:

body surface area (usually in square meters)

BSBE:

breath sounds bilateral and equal

BTBV:

beat to beat variabilityBT Shunt :

Blalock-Taussig Shunt .

BQ:

blood flow

buffer:

a chemical system that prevents change in concentration of another chemical

substance; a substance which acts in a solution to resist any change in pH of

the solution when acid or base is added; the combination strong acid and a

week conjugate base.

Percentage of Buffers in Whole Blood

Hemoglobin & Oxyhemoglobin 35%
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Phosphate 5%

Plasma Proteins 7%

Total non-bicarbonate - 47%

Plasma Bicarbonate 35%

RBC Bicarbonate 18%

Total bicarbonate - 53%

TOTAL BUFFER 100%

BUN:

blood urea nitrogen

bundle branch block:

An ECG change characterized by an intraventricular conduction delay

affecting the left ventricular wall and septum. Acute occurrences most

commonly result from myocardial ischemia.BVH:

biventricular hypertrophy

C

CABG:

coronary artery bypass graft

CABRI:

coronary artery bypass revascularizationinvestigation

CAD:

coronary artery disease

calcium channel blocker:

drug that blocks entry of calcium into cells and inhibits the contractility of

smooth muscle, resulting in dilation of blood vessels and reduction in blood

pressure

cannula(e):

tubes or catheters placed in the great vessels orcardiac chambers to allow

decompression or selective propulsion of blood flow to the structure or vessel

capillaries:

the smallest blood vessels in the body that connect arterioles and venules(CO2)carbon dioxide:

a colorless, odorless nonflammable produced in respiration, and given off by

the tissue to the blood

carbonic acid(H2CO3):

an weak acid resulting from the reaction of H20 and CO2 to form H2CO3

which dissociates into H+ and HCO3-

carbonic anhydrase :

an enzyme found primarily in the kidney and red blood cells that accelerates

the reversible reaction of H20 and CO2 to form H2CO3-

cardiac:

of or referring to the heartcardiac mortality:
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death due to cardiac cause

cardiac catheterization:

passage of a catheter into the heart through a blood vessel leading to the heart

for the purpose of measuring intracardiac pressure abnormalities, obtaining

cardiac blood samples, and/or imaging cardiac structures by injection of radio-

opaque dyecardiac output:

the volume of blood displaced by the left ventricle over one minute

cardiac index:

cardiac output normalized to body surface area or body weight

cardiogenic shock:

failure to maintain blood supply to the tissues because of inadequate cardiac

output, such as may be caused inmyocardial infarction

cardiomegaly:

hypertrophy of the heart

cardiomyopathy:

a general diagnostic term designating primary myocardial diseasecardioplegia:

1. interruption of myocardial contraction, as by use of chemical compounds or

cold in cardiac surgery

2. a solution infused into the heart to interrupt myocardial contraction

cardiopulmonary:

pertaining to the heart and lungs

cardiopulmonary bypass :

use of an extracorporeal circuit to circulate blood around the heart and lungs

cardiopulmonary resuscitation:

an emergency measure to maintain a person's breathing and heartbeat when

they have stopped as a result of myocardial infarction, trauma, or other

disorder.

cardiotomy:

1. surgical opening in the heart

2. component of extracorporeal circuit serving as a reservoir for blood

carotid:

referring to the large arteries in the neck carrying blood to the brain and scalp

catecholamine :

any of a group of sympathomimetic amines (including dopamine, epinephrine,

and norepinephrine)

cath: catheterization

CAVH:

continuous arterio-venous hemofiltration

CBC:

complete blood count

CCP:

Certified Cardiovascular Perfusionist; the professional credential for the

certified perfusion technologist

CCSC:

Canadian Cardiovascular Society Classification

CCU:coronary care unit
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cerebral:

referring to the cerebellium or brain

CHD:

congenital heart disease

CHF:

congestive heart failurecholesterol :

chol, a monatomic alcohol found in animal fats and oils, bile, blood , brain

tissue, milk, egg yolk, myelin sheaths of nerves, liver, kidneys and adrenal

glands, increased blood levels of which are a risk factor for the development

ofcoronary artery disease

chronic obstructive pulmonary disease (COPD):

group of conditions in which the patient has an expiratory airflow obstruction

such as chronic bronchitis or emphysema

CI:

1. cardiac index,

2. confidence intervalcirc art:

circumflex artery

CK:

creatinine kinase

clot:

see thrombus

CMV:

cytomegalovirus

CO:

cardiac output

c/o:

complaining of

coag:

coagulation

coar/Ao:

coarctation of the aorta

colloidal osmotic pressure (COP) :

the osmotic force due to the presence of proteins or other large molecular

weight substances

co-morbidity:

concomitant but unrelated pathologic or disease process,usually used toindicate coexistence of two or more disease processes.

compensation:

the process where one acid base imbalance offsets another imbalance in an

effort to bring the pH back within normal limits. Ex. metabolic acidosis with a

[HCO3-] less than 22 mEq/L causes tachypnea causing a pCO2 less than 35

mmHg (respiratory alkalosis)

congestive heart failure :

failure of the heart to maintain adequate circulation of blood.

COP:

colloidal osmotic pressure

COPD:chronic obstructive pulmonary disease
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cor:

heart

coronary :

encircling in the manner of a crown; especially to the arteries of the heart,and

by extension, to pathologic involvement of them

coronary sinus:the opening into the right atrium to which the veins of the left coronary

circulation drain

coronary artery bypass graft :

vein or artery grafted surgically to permit blood to travel from theaorta to a

branch of the coronary artery at a point past an obstruction.

coronary artery disease (CAD):

Although a number of disease processes other than atherosclerosis can involve

coronary arteries, in this guideline the term CAD refers to the atherosclerotic

narrowing of the major epicardial coronary arteries.

coronary thrombus:

blood clot that obstructs a blood vessel of the heartcoronary stenosis:

narrowing or constriction of any arteries, orifices or chambers leading into or

from the heart

C/P:

cardiopulmonary

CPB:

cardiopulmonary bypass

CPK:

creatine phosphokinase

CPR:

cardiopulmonary resuscitation

Cr:

creatinine

Cr cl:

creatinine clearance

CRF:

chronic renal failure

CRI:

chronic renal insufficiency

cross-matching:

the mixing of a donor's blood with a potential recepient's blood to test forcompatibility

cryoprecipitate:

the thin white layer obtained from freezing and thawing blood

CTICU:

cardiothoracic intensive care unit

CVP:

central venous pressure

cx:

circumflex artery

CXR:

chest x-ray
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D

D1 or D2:

diagonal branch of the LAD artery

D5W:dextrose 5% in water

DBP:

diastolic blood pressure

D/C:

discontinue / discharge

Defib:

defibrillate

DHCA:

deep hypothermic circulatory arrest

dialysis :

the process of separating crystalloids and colloids in solution by the difference

in their rates of diffusion through a semipermeable membrane, used to remove

metabolites and toxins from body fluids

diastole :

referring to the period of time during relaxation of the ventricle(s)

DILV:

double inlet left ventricle

DIC:

disseminated intravascular coagulapathy; an abnormal process that occurs

when clot formation and clot lysis occurs simultaneously in the

microcirculationdiffusion :

the spontaneous mixing of the molecules of two or more substances from an

area of high concentration to low, resulting from random thermal motion: it's

rate is proportional to the concentrations of the substances and increases with

the temperature

DKS:

Damus-Kaye-Stansel

DM:

diabetes mellitus

DORV:

double outlet right ventricleDOLV:

double outlet left ventricle

DOE:

dyspneaon exertion

DVT:

deep venous thrombosis

dx:

diagnosis

dyspnea :

shortness of breath, difficulty breathing

E
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EAST:

Emory Angioplasty Study Trial

ECA:

external carotid artery

ECC:extra-corporeal circulation (or circuit); the propulsion of blood outside the

body to perform an artificial organ function

ECCO2R:

extra-corporeal carbon dioxide removal; the agressive removal of carbon

dioxide from a portion of the venous blood before it enters the right atrium to

provide support to a patient in respiratory failure

ECD:

endocardial cushion defect

ECG :

electrocardiogram

ECHO:echocardiogram

echocardiography:

the process of reflecting ultrasound doppler signals off the heart and

surrounding anatomical structures to visualize cardiac activity and structure,

and acilitate diagnosis

ECMO:

extracorporealmembrane oxygenation; the process of propelling blood outside

the body (often in neonates, or newborns) to perform artificial ventilation of

the blood with a blood oxygenator that allows for diffusion of oxygen and

carbon dioxide across a continuous membrane material separating gas and

blood

ECT:

Extracorporeal Circulation Technology; the study of maintaining blood flow

outside the body to perform artificial organ(s) functions

-ectomy:

to surgically excise

EEG:

electroencephalogram

EF:

ejection fraction; the percent of the left ventricular volume that is ejected in

one cardiac contraction; stroke volume divided by ventricular end-diastolicvolume

ejection fraction (EF):

the percent of the left ventricular volume that is ejected in one cardiac

contraction; stroke volume divided by ventricular end-diastolic volume

EKG:

electrocardiogram

embolus:

a small solid particle or gas bubble that is carried in the blood flow stream;

(plural is emboli)

EMT:

1. emergency medical transport;2. emergency medical technitian
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gaseous microemboli; a small embolus of gas that is carried in the blood flow

stream

great vessels:

the large arteries and veins arising from the heart and pericardium

GTT:

glucose tolerance test

H

H+:

hydrogen ion, also known as a proton

haldane effect:

the influence of oxygen on the affinity of hemoglobin to bind with carbon

dioxide, increasing the oxygen level decreases the affinity of hemoglobin for

carbon dioxide

[HCO2-]:

bicarbonate ion concentration in mEq/L. The bicarbonate ion is the most

important base in the body. The amount of HCO2- in the blood is expressed in

mEq/L and is regulated by the kidneys. The kidneys regulate the [HCO2-] by

increasing or decreasing the resorption of HCO2- in the renal tubule. The

HCO2- is the metabolic component of the acid-base balance. The normal

[HCO2-] is maintained between 22 - 26 mEq/L with a mean of 24 mEq/L

hct:

hematocrit

HCTZ:

hydrochlorothiazide, (type of diuretic)hematocrit :

the percent of the blood which is cellular elements, normally 35 - 43 %

hemo-:

referring to blood

hemoconcentration:

the process of removing fluid and electrolytes from the blood to increase the

concentration of hemoglobin and red blood cells

hemodialysis:

the separation of waste products from the blood by osmosis across a semi-

permeable membrane

hemodilution:the decrease in the concentration of hemoglobin and red blood cells in the

blood

hemodynamic instability:

i nstability of the blood pressure.

hemoglobin :

the red pigmented complex protein found in the red blood cells that functions

to carry oxygen and carbon dioxide

hemolysis :

the freeing of hemoglobin from the inside of the red blood cell by normal

breakdown or mechanical destruction

hemostasis :the cessation of bleeding through normal coagulation or by surgical procedure
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Henderson - Hasselbach equation:

pH = pK + log [HCO2-]/[CO2d][H2CO3]

pH = pK + log [HCO2-]/(0.03 * pCO2)

(The carbon dioxide solubility coefficient 0.03 converts pCO2 in mmHg to

mm/L, the pK is 6.10 at 37oC). Relates the ratio of the metabolic component to

the respiratory component.heparin :

a negatively charged polysaccharide normally found in lung or gut mucosa

that naturally prolongs the time it takes blood to clot by catalyzing anti-

thrombin III

hepatic :

pertaining to the liver

hepatitis:

inflammation of the liver usually caused by a virus transmitted by contact or

blood transfusion

hepatomegaly:

enlargement of the liverheterograft:

see xenograft

heterologous:

referring to a different species, or tissue coming from a different species

heterothermic:

cold blooded; poikilothermic; animals whose body temperature changes with

the environment

Hgb:

hemoglobin

hirudin :

coagulation inhibitor isolated from leeches, inhibits thrombin without

requiring ATIII

HIV:

human immunodeficency virus; a retrovirus that converts RNA to DNA and

inserts it in the host cell, and is responsible for the fatal disease AIDS

HLHS :

hyperplastic left heart syndrome; congenital defect characterized by atretic

underdeveloped or absent left ventricle

HMD:

hyaline membrane disease

H/O: history of

homeostasis:

the maintanence of a normal state of balance in a physiologic system

homeothermic:

warm blooded; animals whose body temperature are maintained within a

narrow range by its metabolic processes

homograft:

see allograft

homologous:

referring to the same species, or tissue coming from the same species

HR:heart rate
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HTN:

hypertension

Hx:

history

hydrogen ions (H+)

ion produced when hydrogen looses an electron, a proton, the ions releasedwhen an acidis placed in solution such as in water orplasma

hyper:

above normal

hypercapnea :

a measurement of an abnormally highCO2level in the blood, pCO2 > 45

mmHg

hypercholesterolemia :

excessive cholesterol in the blood.

hyperlipidemia:

excessive quantity of fat (cholesterol and triglycerides) in the blood.

hyperthermia:temperature above normal

hypertrophiccardiomyopathy:

disease of the myocardium produced by the enlargement of the cells of the

myocardium; often the result of increased oxygen demand in ischemic heart

disease.

hypertrophy :

enlargement or overgrowth of an organ or part due to increase in seze of its

constituent cells.

hypervolemia :

blood volume increase above normal

hypo:

below normal

hypoperfusion :

decreased blood flow to an organ or tissue such as in shock

hypotension :

decrease of systolic and diastolic blood pressure below normal.

hypothermia :

temperature below normal

hypovolemia:

decreased blood volume below normal

hypoxemia:reduction of oxygen level in the blood below normal

hypoxia :

reduction of oxygen level in tissues below normal

I

IABP:

intra-aortic balloon pump

ICA:

internal carotid arteryICS:
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intercostal space

ICU:

intensive care unit

IDDM:

insulin dependent diabetes mellitus

immune system:the system of blood cells and chemicals that protects the body from invasion

by foreign organisms; the system that produces antibodies in response to

antigens

in situ:

in place, but isolated in a living organism

intima:

an innermost structure (seetunica intima)

in vitro:

in the laboratory or in the test tube outside a living organism

in vivo:

within a living organisminterstitial:

between cells; the space in the tissues between cells outside the vascular

system

intra-aortic balloon pump :

Use of a balloon attached to a catheter inserted through the femoral artery into

the descending thoracic aorta for producing alternating inflation and deflation

during diastole and systole, respectively.

intra-coronary stenting:

use of a prosthetic metal device to provide and maintain an enlarged coronary

lumen at the site of an obstructiveatheroscleroticplaque.

I&O (I/O):

intake and output

ischemia:

the need for oxygen exceeds the supply of oxygen leading to tissue cellular

damage and possible death ornecrosis

ischemic heart disease:

a form of heart disease whose primary manifestations result from myocardial

ischemia due to atheroscleroticCAD.

isthmus:

a narrow connection between two larger bodies or parts

IV: intravenous

IVC:

inferior vena cava

IVCD:

interventricular conduction defect

J

JVD:

jugular venous distention
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K

Konno:

Surgical procedure to treat patients with congenital aortic stenosis.

L

KVO:

keep vein open

L

LA LA:left atrium

LAD:

left anterior descending coronary artery

LBBB:

leftbundle branch block

LDH:

lactate dehydrogenase

left ventricular function:

function of the main pumping chamber of the heart (left ventricle) that

receives blood from the leftatrium and pumps it out into the general

circulation through the aortic valve.left main (LM) disease:

stenosis of the left main (LM) coronary artery.

LIMA :

left internal mammary artery

LLL:

left lower lobe

LM:

left main coronary artery.

LV:

left ventricle

LVH:left ventricualr hypertrophy

lysis:

destruction or decomposition, as of a cell or other substance

M

MAP:

mean arterial pressure

MB:

cardiac muscle
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mec:

meconium

media:

middle,(see tunica media)

mediastinum :

The mass of tissues and organs separating the sternum in front and thevertebral column behind, containing the heart and its large vessels, trachea,

esophagus, thymus, lymph nodes, and other structures and tissues

metabolic:

refers to the process of the chemical reactions at the tissue level

metabolic acidosis:

abnormal physiological process characterized by the primary gain of strong

acid or primary loss of bicarbonate from the extracellular fluid. Reflected by a

low [HCO3-] and low pH. (HCO3

- less than 22 mEq/L) Treat by increasing

perfusion of tissues and give NaHCO3.

metabolic alkalosis:

mbnormal physiological process characterized by primary gain of strong baseor loss of strong acid. Reflected by a high [HCO3

-] and high pH. (HCO3-

greater than 26 mEq/L) Normally no need to treat.

MI:

1. mitral insufficiency; back flow or regurgitation of flow through the mitral

valve during ventricular systole

2. myocardial infarction

MICU:

medical intensive care unit

milliequivalent:

one thousandths of an equivalent: An equivalent is the amount of a substance

(mg or mM) that can enter into a reaction with one mole of hydrogen ions, or

replace one mole of H+ in the reaction (gram molecular weight/valence).

mitral :

referring to the bicuspid valve separating the leftatrium and ventricleto

prevent back flow into the atrium during ventricularsystole

mitral regurgitation :

abnormal systolic back flow of blood from the left ventricle into the left

atrium, resulting from imperfect closure of the mitral valve

mitral stenosis :

mitral valvular stenosis;narrowing of the normal area of the mitral valvecausing a pressure drop across the valve during left ventricular filling

modified ultrafiltration :

hemoconcentration of patients blood, post bypass prior to decannulation, using

the extracorporeal circuit for blood access

mole:

the gram molecular weight of any substance, which always contains 6.023 X

1023 molecules of that substance. The number of molecules of a substance in

one gram molecular weight of the substance. one mole of hydrogen ions, or

replace the H+ in the reaction (gram molecular weight/valence).

MR:

mitral regurgitationMS:
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1.mitral stenosis

2. multiple sclerosis

MUF:

modified ultrafiltration

MUGA:

multiple gated acquisition test; a radionuclide test of myocardial performancemultivessel disease:

disease in two or more of the coronary arteries

MV :

mitral valve

MVR:

mitral valve repair, or replacement; open heart surgery to repair or replace a

diseased mitral valvewith a prosthesis or artificial heart valve

myocardial ischemia:

condition in which oxygen delivery to and waste removal from the

myocardium falls below normal levels with oxygen demand exceeding supply.

myocardial infarction (Ml):damage to the heart muscle caused by occlusion of one or more of the

coronary arteries.

myocardium :

the muscular wall of the heart located between the inner endocardial layer and

the outer epicardial layer.

N

necrosis :death of individual cells or groups of cells, or of localized areas of tissue

NHLBI:

National Heart, Lung, and Blood Institute

NIDDM:

non-insulin dependent diabetes mellitus

nitrate:

a drug whose metabolites produce a relaxation of vascular smooth muscle,

causing dilation of the veins, reducing preload andmyocardial oxygen

demand.

nitrogen:

chemical element at. no. 7, symbol N, molecular N2. It forms about 78% ofthe atmosphere and 78% of dissolved gas in the blood

N/G:

naso gastric

NICU:

neonatal intensive care unit

NKA:

no known allergies

NKDA:

no known drug allergies

non-Q-wave myocardial infarction:

myocardial infarction that is not associated with the evolution of new Q waveson the ECG.
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npo:

nothing by mouth

NSR:

normal sinus rhythm

NTGNTG:

nitroglycerin

O

OHDC:

oxyhemoblobin disassociation curve

obtuse marginal:

branches of the circumflex coronary artery

OM1 OM2:

obtuse marginal

osmosis:

the passage of pure solvent from a solution of lesser to one of greater solute

concentration, when the two solutions are separated by a membrane which

selectively prevents the passage of solute molecules, but is permeable to the

solvent

osmotic pressure :

the negative pressure created by a dissolved non-diffusable substance across a

membrane permeable to solvent but not to the solute

ostia:

opening

-otomy:to make a surgical opening into

oxygen :

chemical element at. no 8, symbol O, molecular O2; an odorless, colorless gas

that is essential to all plants and animals for respiration

oxygenator :

an artificial device that functions like the lung to exchange oxygen and carbon

dioxide with the blood

P

P50:

hemoglobin P50, the partial pressure of oxygen where hemoglobin is 50%

saturated with oxygen, normally about 27 mmHg

PA:

pulmonary artery

PAC:

premature atrial contraction

PaO2 :

the partial pressure exerted byO2dissolved in arterial (a)plasma and RBC

water,(in the venous blood - PvO2)

PFO:patent foramen ovale
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PaCO2 :

the partial pressure exerted byCO2dissolved in arterial (a)plasma and RBC

water, (in the venous blood - PvCO2)

palliative:

to relieve the symptoms of without fixing or repairing the underlying

conditionpartial pressure :

the pressure exerted by a gas dissolved in plasma and RBC water, for example

pO2 is the partial pressure exerted by dissolved oxygen

pCO2 :

The partial pressure (tension) exerted by CO2 in mmHg. The respiratory

component. Carbon dioxide (CO2) is produced by metabolism and carried by

the blood to the lungs where it diffuses into the alveoli and is eliminated by

exhaled breath. The amount of CO2 dissolved in the blood is measured by the

partial pressure it exerts and is reported in mmHg. When CO2 dissolves in H2O

it combines to form H2CO2 (carbonic acid) the most important acid in the

body. The [H2CO2] is directly proportional to the CO2 dissolved in the blood(paCO2) and the paCO2 is a measurement of the ventilation status of the

patient. Therefor the paCO2 is known as the respiratory component of the acid-

base balance. As with pH, the body maintains the pCO2 within strict limits.

The normal pCO2 is 35 - 45 mmHg with a mean of 40 mmHg.

PCWP:

pulmonary capillary wedge pressure

PDA:

1. patent ductus arteriosus

2. posterior descending artery

PE:

1. pulmonary embolus

2. pulmonary edema

3. peripheral edema

percutaneous transluminal coronary angioplasty (PTCA):

percutaneous transluminal coronary angioplasty; compression of an

athromatous lesion by inflating an intracoronary balloon catheter to dilate the

vessel

PERLA:

pupils equal and reactive to light and accommodation

perfusion :

1. flowing over or through;2. blood flow through the organs and tissues of the body;

3. the profession of the study and implementation of blood flow through an

extracorporealcircuit for life support

perfusion scan:

a test to determine the status of blood flow to an organ.

perfusion balloon angioplasty:

a variation of PTCA in which a catheter is inserted in the artery that permits

blood flow during balloon inflation.

perfusionist :

see perfusion technologist

perfusion technologist:
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perfusionist; the health professional educated to operate the heart lung

machine and other life support devices

peri-:

surrounding, around

pericardium :

the tough non-elastic membrane surrounding the heart that attached to thegreat vessels and other anatomical structures in the mediastinum

pericarditis :

inflamation of the pericardium

pH :

the inverse log of the hydrogen ion activity; a measure of the alkalinity or

acidity of the blood or solution on a 14 point scale with 1 being acidic and 14

being alkaline. The body normally maintains the [H+] and therefor the pH

within very strict limits. Normal pH is 7.35 - 7.45 with a mean of 7.40.

PH2 O:

water vapor pressure, thepartial pressureexerted by the presence of water

vaporphagocyte :

a white blood cell that engulfs and distroys foreign organisms and debris in the

blood

pharmacologic stress test:

a test of heart function during intentional drug-induced stress.

pH stat :

ventilation scheme where the total CO2 increases as the temperature falls and

the temperature corrected ABG appears normal. So called because the

temperature-corrected, actual blood pH equals 7.40 during all temperatures of

CPB

PI:

pulmonary insufficiency

PICU:

pediatric intensive care unit

PJC:

premature junctional contractions

pK:

a constant that describes the rate or degree to which a chemical reaction goes

to completion, depending on temperature and pH

plasma free hemoglobin:

hemoglobin released from dying or damaged red blood cellsplasma :

the acellular, colorless liquid portion of the blood

plasmin :

the substance found in the blood that digests fibrin resulting in clot dissolution

plasminogen :

the precursor to plasmin that is activated by tissue plasminogen activator

(TPA)

platelet :

thrombocyte;

PND:

paroxysmal nocturnal dyspneapO2:
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partial pressure of oxygen; Oxygen is used by the body as a metabolic

substrate to produce energy. A constant supply of oxygen is needed to

maintain living tissue. 21% of the air we breath is oxygen and at sea level it

exerts a pO2 of ~159 mmHg. The air is taken into lungs with each inhalation

and moved into the alveoli where the pO2 is ~100 mmHg. The O2 diffuses into

the blood and dissolves in the plasma where it exerts a pO2 of ~95 mmHg. Innormal arterial blood with a pO2 of ~95 mmHg the blood is ~98% saturated

with oxygen. The oxygen is carried to the tissue by the blood and by the time

the venous blood returns to the lungs it has a pO2 of ~40 mmHg and is ~75%

saturated. The paO2 is assessed on the ABG to provide a measure of the

arterial oxygenation.

poikilothermic:

cold blooded; heterothermic; animals whose body temperature changes with

the environment

polycythemia :

a serious condition characterized by too many red blood cells in the circulation

pooled platelets:platelets collected from multiple donors and mixed together for use in

transfusion

post-Ml angina:

angina occurring from 1 to 60 days after an acute MI.

PR interval:

ECG PR segment, interval of time between the P wave and the R wave on the

ECG

prime (pump):

1. to fill the extracorporeal circuit with fluid;

2. the fluid that is required to initially fill and debubble the extracorporeal

circuit before connection to the patient's vascular system

prinzmetal's angina:

variant angina, a clinical syndrome of rest pain and reversible ST-segment

elevation without subsequent enzyme evidence of acute MI. In some patients,

the cause of this syndrome appears to be coronary vasospasm alone often at

the site of an insignificant coronary plaque, but a majority of patients with

variant angina have angiographically significant CAD.

PS:

pulmonary valvular stenosis;

PT:

prothrombin time, protimePTCA:

percutaneous transluminal coronary angioplasty;

PTT:

partial thromboplastin time

pulmonary :

referring to the lung or the bicuspid valve separating the right ventricle and the

pulmonary artery to prevent back flow into the ventricular during diastole

pulmonary edema:

condition, usually acute, but sometimes chronic, where fluid builds up in the

lungs. This often occurs as a response to left ventricular failure in ischemic

heart disease, hypertension, or aortic valve disease.pulmonary atresia :
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small or undeveloped pulmonary valve

pulmonary insufficiency :

pulmonary valvular incompetence; back flow or regurgitation of flow through

the pulmonary valve during ventricular diastole

pulmonary stenosis :

pulmonary valvular stenosis; narrowing of the normal area of the pulmonaryvalve causing a pressure drop across the valve during left ventricular systole

pump:

1. the blood propulsion device included in the extracorporeal circuit to replace

the left ventriclar function

2. slang for the heart

pumptech:

1. slang for the technologist that is aperfusionist

2. atechnician that is responsible for operating heart lung machine durring

surgery

3. a member of the 'pump team'

PV :pulmonary valve

PVC:

premature ventricular contraction

PVD:

peripheral vascular disease

PVR:

1. pulmonary vascular resistance; resistance to the flow of blood through the

pulmonary vascular beds

2. peripheral vascular resistance; resistance to the flow of blood through the

peripheral vascular beds

3. pulmonary valve repair, or replacement; open heart surgery to repair or

replace a diseased pulmonary valve with a prosthesis or artificial heart valve

valve

Q

QIP:

quality improvement process

R

RA:

right atrium

radionuclide test:

A diagnostic test in which a radioactive substance is injected into the

bloodstream and the emitted radioactivity is detected by a scanner; used to

visualize the heart and vessels.

RBBB:

right bundle branch block

RBC :red blood cell; erythrocyte
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RCA:

right coronary artery

renal:

referring to the kidney(s)

renal failure:

failure of the kidney to cleanse the blood causing the build up of wasteproducts in the blood

respiration :

the chemical processes that occur at the tissue cellular level converting oxygen

and water to heat, ATP and carbon dioxide

respiratory acidosis:

an abnormal physiological process in which there is a primary reduction in

alveolar ventilation relative to the rate of CO2 production. Reflected by a high

pCO2 and low pH. (pCO2 greater than 45 mmHg) Treat by increasing

ventilation.

respiratory alkalosis:

an abnormal pyhsiological process in which there is a primary increase in therate of alveolar ventilation relative to the rate of CO2 production. Reflected by

a low pCO2 and high pH. (pCO2 less than 35 mmHg) Treat by decreasing

ventilation.

re-stenosis:

the recurrence of a stenosis

retrograde:

against the normal direction of flow

revascularization :

restoration, to the extent possible, of normal blood flow to the myocardium by

surgical or percutaneous means or with removal or reduction of an obstruction

as occurs when CABG orPTCA is performed

RH:

relative humidity

Rh:

rhesus monkey factor

RHD:

rheumatic heart disease

RIMA:

right internal mammary artery

RISC:

Research Group on Instability in Coronary Artery DiseaseRisk:

high, intermediate, and low risk in this guideline refer to the probability of

future adverse cardiac events, particularly death orMI.

RITA:

Randomized Intervention Treatment of Angina

RM:

Right Main Coronary Artery

RRR:

regular rate and rhythm

RV:

right ventricleRVH:
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right ventricular hypertrophy

Rx:

therapy or treatment

S

SA node:

sinoatrial node

SBP:

systolic blood pressure

SCOPA:

South Carolina Organ Procurement Agency

sed. rate:

erythrocyte sedimentation rate

SEM:

systolic ejection murmur

SGOT :

serum glutamic oxaloacetic transaminase (AST)

SGPT :

serum glutamic pyruvic transaminase

shock :

acute peripheral circulatory failure due to derangement of circulatory control

or loss of circulating fluid, marked by hypotension, coldness of skin, usually

tachycardia, and often anxiety; decreased cardiac output;

sinus node :

bundle of excitatory tissue found in the right atrium that functions as thepacemaker of the heart

Sinus of Valsalva :

the portion of the aortic root just distal to the aortic valve containing the

coronary ostia

sO2:

percent saturation of hemoglobin with oxygen, in the arterial blood - SaO2, in

the venous blood - SvO2

solubility:

the ability of a gas to dissolve into plasma and RBC water

S tach:

sinus tachycardiastenosis :

a narrowing or blockage of a coronary artery

STICU:

surgical trauma intensive care unit

sublingual:

beneath the tongue.

supraventricular arrhythmia:

an irregular heart beat that originates in the atriaor AV node.

SV:

a device placed in an vessel to keep it open, coronary stent

SV:stroke volume
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SVCSVC:

superior vena cava

SVG:

saphenous vein graft

SVO2:

mixed venous oxygen saturationSVR:

systemic vascular resistance ([MAP-CVP]/CO)

SV tach:

supraventricular tachycardia

systole :

referring to the period of time during contraction of the ventricle(s)

T

TAPVR:

total anomalous pulmonary venous return

TEE:

transesphogeal echocardiography, a doppler echocardiographic transducer is

inserted in the esophogus to visualize the lungs, heart and great vessels

technician:

a person highly skilled in a certain field or process

technologist:

a person who applies scientific knowledge in a specialized field or process

temperature correction:

The mathematical process to correct for the physical changes that pH, pO2,pCO2 go through when a blood sample is warmed or cooled in vitro during

analysis.

tetralogy of fallot (TOF):

congenital heart condition characterized by; 1. over riding aorta, 2. VSD, 3.

RV outflow tract obstruction and, 3. PDA, if ASD is present the condition is

called a "pentology of fallot"

TGA:

transposition of the great arteries

thebesian veins:

the small veins terminating into the right sided chambers of the heart draining

the right coronary circulation of the heartthrombocytopenia:

abnormal decrease in number of the blood platelets.

thrombocyte :

platelet; the small, disc shaped enucleated body found in the blood that

initiates the coagulation process

thrombolytic therapy:

Pharmacologic treatment with a class of drugs that can break up fibrin blood

clots.

thrombus :

blood clot, blood that has gone from a liquid state to a gel to stop bleeding

tricuspid atresia :small or undeveloped tricuspid valve
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TI:

tricuspid insufficiency

TM:

thrombolysis in myocardial infarction

TIA:

transient ischemic attackTOF:

tetralogy of Fallot

total CO2 content:

consists of HCO3-, H2CO3, and dissolved CO2 (pCO2). (Since CO2 and H2CO3

are interchangable) total CO2 = dissolved CO2 gas + HCO3-. or total CO2 =

HCO3- + (0.03 * pCO2). (The CO2 solubility coefficient, 0.03, converts pCO2

in mm/L to meq/L) In normal plasma, more than 95% of the total CO2 is

contributed by HCO3-, the other 5% by dissolved CO2 and H2CO3.

TPA:

tissue plasminogen activator; a substance that convertsplasminogen to

plasmin to dissolve clotTR:

tricuspid regurgitation

trans-:

across or through

transcutaneous :

through the skin

transfusion :

the injection of whole blood or blood products into the blood stream

transvenous pacemaker:

cardiac pacemaker using a pacing electrode or wire passed through a vein into

the chambers of the heart that stimulates and maintains a normal heart rate;

may be permanent or temporary

triage:

screening and classification of sick, wounded, or injured persons to determine

priority of need and proper place of treatment

tricuspid valve:

the valve between the right atrium and the right ventricle

TS:

tricuspid stenosis; stenosis of the tricuspid valve

tunica:

in anatomy, a general term for a membrane or other structure covering orlining a body part or organ

t. adventitia the outer coat of various tubular structures including blood

vessels

t. intima the innermost coat of a blood vessel

t. media the middle coat of a blood vessel

TV :

tricuspid valve

U

UAC:
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umbilical artery catheter

UO:

urine output

ultrafiltration:

the separation of fluid and electrolytes from the blood by seiving across a

porous membraneunstable angina:

angina or chest pain that occurs at rest, new onset of pain with exertion, or

pain that has accelerated (more frequent, longer in duration, or lower in

threshold).

V

VA:

Veterans Administration

VAD:

ventricular assist device; a blood propulsion devices or ECCs to assist the

failing right or left ventricles

valvuloplasty :

surgical repair of a cardiac valve

valvulotomy :

to make an incision into a diseased and stenosed cardiac valve to increase the

valve area

variant angina:

prinzmetal's angina, a clinical syndrome of rest pain and reversible ST-

segment elevation without subsequent enzyme evidence of acute MI. In somepatients, the cause of this syndrome appears to be coronary vasospasm alone

often at the site of an insignificant coronary plaque, but a majority of patients

with variant angina have angiographically significantCAD.

vasa vasorum:

the small blood vessels providing nutrient blood flow to largearteries and

veins

vascular :

pertaining to blood vessels or indicative of a copious blood supply

vasoconstrict:

the arterioles decrease in diameter restricting blood flow to an organ or portion

of the bodyvasodilate:

the arterioles increase in diameter allowing more blood flow

vein :

a blood vessel that carries blood toward the heart; veins usually carry

deoxygenated blood

vena cava (e):

the large vein(s) collecting the venous return from the head, neck and

shoulders (superior vena cava) and the legs and gut (inferior vena cava)

draining into the right atrium of the heart

ventilation :

the movement of gas in and out of the lungs to facilitate blood oxygenationandcarbon dioxide removal
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ventricle :

a small cavity or chamber, as in the brain or heart

right v. the lower chamber of the right side of the heart, which pumps venous

bloood through the pulmonary trunk and arteries to the capillaries of the lung

left v. the lower chamber of the left side of the heart, which pumps oxygenated

blood out through the aorta to all the tissues of the bodyventriculography:

a procedure for visualization ofventriclesof the heart by x-ray after injection

of a radio opaque contrast dye.

V fib:

ventricular fibrillation

Von Willebrand Disease :

coagulation disorder caused by lack of or non functional Von Willebrand

Factor

VSD:

ventricular septal defect

V tach:ventricular tachycardia

VWF:

Von Willebrand Factor

W

WBC:

white blood cell(s), leukocyte(s); neutrophils, basophils, esonophils,

monocytes, and lymphocytesWNL:

within normal limits

X

XC:

cross clamp

xenograft :

tissue taken from another species, treated and implanted

Y

Y Connector:

bifurcation junction resembling alphabet "Y" used for dividing or merging the

flow through two pieces of tubing

Z

Other Glossary Links
http://www.musc.edu/perfusion/glossary.htm#ventriclehttp://www.musc.edu/perfusion/glossary.htm#ventriclehttp://www.musc.edu/perfusion/glossary.htm#ventriclehttp://www.musc.edu/perfusion/glossary.htm#ventricle


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Case Report - Stenting With Intravenous Abciximab Infusion

from Journal of Invasive Cardiology

Case Report

A 67-year-old female patient complained of exertional precordial chest pain with

radiation to the left shoulder occurring over a two-month period. The pain was

aggravated by minor activities, such as household chores or walking, and relieved by

rest. The frequency and severity of the chest pain had been increasing during the past

2 months with the last episode of chest pain lasting for 1 hour on the morning of

admission. The patient was admitted to our hospital under the impression of unstable

angina. She had a 20-year medical history of hypertension. Diabetes mellitus had been

diagnosed 5 years ago. The patient had been on antihypertensives and oral

hypoglycemic medications for 2 months. Her echocardiogram (ECG) on admission

revealed a symmetrical T-wave inversion in the precordial leads from V1 to V5

(Figure 1). Since the value of CK-MB and Troponin-T were slightly elevated up to

7.38 ng/ml and 1.83 ng/ml, respectively (normal values: 0-5 ng/ml and 0-0.1 ng/ml,

respectively), acute non-Q wave anterior myocardial infarction was diagnosed.

Figure 1. (click image to zoom) Echocardiogram on admission revealed

symmetrical T-wave inversion in the precordial leads from V1 to V5.

On the third day of admission, coronary angiography revealed two-vessel disease with

73% luminal narrowing of the proximal left anterior descending coronary artery

(LAD) (Figure 2) and 50% luminal narrowing of the mid-right coronary artery(RCA). It was decided to perform PTCA with stenting of the proximal LAD lesion.

Following predilatation with a 3.5 x 20 mm Omnipass balloon (Cordis Corporation,

Warren, New Jersey), the 3.5 x 16 mm NIR stent (Boston Scientific/Scimed Inc.,

Maple Grove, Minnesota) could not be passed into the lesion. Angiography showed

acute thrombus formation at the left main coronary artery (Figure 3) and the patient

developed severe sudden chest pain with ST-segment elevation in leads Ia, aVF, V5

and V6, which degenerated into ventricular fibrillation (Figures 4A and 4B). The

patient was immediately defibrillated and an intra-aortic balloon pump was inserted

thereafter. After defibrillation, follow-up angiography revealed that the thrombus

embolized into the proximal LAD and the proximal left circumflex artery (LCX)

(Figure 4C). Abciximab infusion was started while a coronary stent (4.0 x 17 mmMAC) was successfully deployed at the left main coronary artery. Follow-up

angiography showed residual stenosis at the proximal LAD and thrombotic occlusion

of the distal intermediate branch. Another MAC stent (3.5 x 17 mm) was successfully

deployed in the proximal LAD. After deployment of the two stents, vital signs were

stable and the patient was transferred to the Coronary Care Unit with no complaints of

chest pain. The activated clotting time during the procedure was 230 seconds. We

performed coronary angiography using Xenetics (Guerbet S.A., France), a non-ionic

contrast agent. After the procedure, the CK-MB was elevated to 393 mg/dL.
http://www.medscape.com/viewpublication/101http://www.medscape.com/content/2001/00/40/74/407481/art-jic1302.03.fig1.jpghttp://www.medscape.com/viewpublication/101


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Figure 2. (click image to zoom) Coronary angiography revealed diffuse

irregular 73% luminal narrowing of the proximal left anterior descending

coronary artery.

Figure 3. (click image to zoom) After predilation with a 3.5 x 20 mm

Omnipass balloon catheter, the stent was still unable to be passed into

the lesion. Follow-up angiography revealed a large thrombus formation

in the left main coronary artery.

Figure 4. (click image to zoom)(A) The patient developed sudden severe chest pain

with ST elevation at leads II, aVF, V5 and V6, (B) which degenerated into ventricular

fibrillation. (C) Coronary angiography revealed that the thrombus embolized into the

proximal left anterior descending coronary artery and proximal left circumflex artery.

One day after the procedure, follow-up coronary angiography revealed patent stents in

the left main and proximal LAD with a remaining thrombotic occlusion of the distal

intermediate branch (Figure 5A) and ECG revealed a right bundle branch block with

precordial T-wave inversion (Figure 5B). The patient was discharged 7 days after

PTCA without chest pain and dyspnea. Follow-up ECG 3 months after discharge

revealed that the precordial T-wave inversions were normalized (Figure 6).

Figure 5. (click image to zoom)(A) One day after percutaneous transluminal coronary

angioplasty with stenting, a follow-up coronary angiography revealed the patent stents

of the left main coronary artery and proximal left anterior descending coron

glossary of heart surgery

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