Topic 1 - ECC Overview

Question 1

CV System Function

Answer 1

• Carry nutrients to cells

- Remove final products/waste from cells

Question 2

Heart function

Answer 2

• Provide blood flow

- Generate blood pressure

Question 3

Vascular system function

Answer 3

• provide path to/from cells
• control blood distribution
• systemic circulation
• pulmonary circulation

Question 4

Components of Vascular system

Answer 4

• Arteries
• Arterioles
• Capillaries
• Venules
• Veins

Question 5

Arteries

Answer 5

• More elastic
• More muscle
• Thick wall
• No valves
• Small lumen

Question 6

Veins

Answer 6

• Less elastic
• Less muscle
• Thin walls
• One way valves
• Large lumen

Question 7

Position of heart

Answer 7

More toward left side of chest and turned so right side is facing anterior

Question 8

AV Valve

Answer 8

• Tricuspid

- Between RA and RV

Question 9

Mitral valve

Answer 9

• aka Bicuspid / Left AV valve

- Between LA and LV

Question 10

CPB main purpose

Answer 10

• Provide surgeon with quiet/bloodless field

- Keep patient’s body and components alive and healthy

Question 11

CPB insertions

Answer 11

• Pick up blood before entering heart from systemic veins

- Return blood to systemic arteries after the heart

Question 12

ECC must do’s

Answer 12

• Replace function of lungs (add O2 / remove CO2)
• Replace function of heart (generate flow and pressure)
• Increase / decrease thermal energy of circulating blood

Question 13

ECC must minimize:

Answer 13

• Coagulation activation

- Inflammatory response

Question 14

CPB is used for:

Answer 14

• Repair of cardiac congenital defects
• Repair of cardiac valves
• placement of CABG
• Heart / lung transplant
• Aortic vascular repair
• VADs
• ECMOs

Question 15

ECC components:

Answer 15

• Pumps
• Oxygenators
• Reservoirs
• Filters
• Safety devices

Question 16

ECC pump

Answer 16

-Move blood / fluid through ECC

Question 17

Arterial pump head

Answer 17

-Replaces function of heart

Question 18

Pump suction

Answer 18

Remove / salvage blood from surgical site

Question 19

Pump vent

Answer 19

Decompresses heart

Question 20

Pump Cardioplegia

Answer 20

Delivers cardioplegia solution to temporarily arrest heart

Question 21

Types of pumps

Answer 21

• Roller (positive displacement pump)

- Centrifugal (kinetic / magnetic spinning pump)

Question 22

Oxygenators

Answer 22

• Artificial lung
• Provide gas exchange (O2, CO2, gas anesthesia)
• Control levels of O2 and CO2 in blood
• Does it over a much smaller surface area compared to real lungs

Question 23

Types of Oxygenators

Answer 23

• Bubble

- Membrane (more commonly used)

Question 24

Reservoir function

Answer 24

• Store blood and fluid
• Provide collection point
• Allows blood to settle and for bubbles to settle out

Question 25

Reservoir types

Answer 25

- Arterial: part of bubble oxygenator system, no longer used - Venous: part of membrane oxygenator / placed before arterial pump and the oxygenator / soft and hard shell bags - Cardiotomy: separate from pump / collects from vent and suction lines

Question 26

ECC Filters function

Answer 26

- Remove unwanted material from blood / fluid/ gases | - Filters out gaseous/particle microemoli, water, bacteria, WBCs

Question 27

Types of ECC filters

Answer 27

- Arterial - Cardiotomy - Prebypass - Gas - Cardioplegia - Transfusion

Question 28

Types of safety devices

Answer 28

- One way valves - Vacuum relief valves - Arterial filter / bubble trap - Low level detectors - Bubble detectors - Pressure monitors - O2 analyzes