CORONARY

REVASCULARIZA
TION CLINICAL
CASE

BY: DAVID ALBERTO JONES PARDO

SEVENTH SEMESTER
 PRIMARY PATIENT
INFORMATION
• THE PRESENT CLINICAL CASE IS OF
MR. ERICK KARTMAN, A PATIENT
WHO PRESENTED AN
ATHEROSCLEROTIC CORONARY
DISEASE WHICH WAS GENERATING
ISCHEMIA
PATIENT'S DATA

HEIGHT: 174CM
WEIGHT: 95 KILOGRAMS AGE: 39
YEARS
FEVII: 47%
• TIPE OF BLOOD: A+
• VIH(-) HEPATITIS B(-)
MEDICAL
HISTORY
• IN HIS RECORD, MR.ERICK PRESENTS
BLINDNESS IN HIS RIGHT EYE AND A
FRACTURE OF THE TIBIA IN THE LOWER
RIGHT MEMBER, SPECIFICALLY THE
TIBIA, SAID FRACTURE WAS REDUCED BY
AN EXTERNAL TUTOR
ANATOMY
• RIGHT CORONARY ARTERY
• LEFT CORONARY ARTERY,
PATIENT HEART
•- The cause is usually the buildup of plaque, which causes the
coronary arteries to narrow and limit the blood supply to the heart.
•Clots can form in these narrowed arteries and block blood flow.

DISEASE Pieces of plaque can also break off and travel to and block smaller
blood vessels.
ASSIGNED PROCEDURE

• MYOCARDIAL REVASCULARIZATION CONSISTS

OF USING AUTOGRAFTS FROM THE PATIENT
FOR THE REVASCULARIZATION OF ARTERIES
THAT ARE OBSTRUCTED WITH LOW
EFFICIENCY FRACTION. IN THIS CASE, GRAFT
OF THE SAPHEA VEIN AND THE MAMMARY
ARTERY WERE USED
    
MEDICAL EQUIPMENT/
INSTRUMENTAL DEVICES SUTURES AND NEEDLES DRUGS AND SOLUTIONS
  -CLOTHING PACKAGE -PROLENE 7/0 OF 3/8 CIRCLE  
VASCULAR
-CORONARY EQUIPMENT -ELECTROBISTURI  
(VASCULAR BASKET) -PROLENE 6/0 OF 3/8 CIRCLE
-RUBBER SUCCIN VASCULAR 13 MM HEPARIN
-SEPARATOR MAMMARY
-BISTURI BLADE 15 (3) -SILK 0 OF ½ OF CIRCLE 26 MM  
-FINE INSTRUMENTAL DR GIRALDO
-BBISTURI BLADE 11 (1) -PROLENE 4/0 OF ½ CIRCLE ROUND SOLUTION SALINE
-STERNAL SEPARATOR (FINOCHETO) RB-1 17 MM
-COOPER TUBE  
-EXTRACORPOREAL EQUIPMENT -POLYESTER 2/0 OF ½ CIRCLE
(MCE) -ASEPTOJERINGE VASCULAR 25 MM INFILTRATION
BUPIVACAINE 0,5%
-RECIPROCATIN SAW - VENIPUNCTURE - PRE-CUT SILK 1
 
  -RADIOPAQUE GAZE - PRE-CUT SILK 4/0
 
  -TUBE OF THORAX 34 -MONOCRYL 3/0 OF 3/8 19MM
TAPPER CUTTING  
  -ANTEROGRADE CARDIOPLEGIA
CANNULA -POLIGLACTIN 910 0 OF ½ CIRCLE  
  36MM
-SET OF TORNIQUETS AND  
  THREAD PASER -POLIGALCTIN 910 2/0 OF ½ CIRCLE 36
 
MM
  -NELATON PROBE 8 FR

CHECK LIST
 
-ACIFLEX 5
  -IOBAN
 
-PACEMAKER WIRE 0
  -INTRA-AORTIC PUNCH
 
  -CO2 GUIDA AND TUBE
 
  -TORUNDAS
 
  -COMPRESSES
 
  -CLIPS LT 100 AND 200
 
  -GLOVES
 
  BONE WAX
 
  - CAIMAN CABLES PACEMAKER
 
  - COKES AND WAIST BAGS
 
  -ARTERIAL CANNULA
 
  -VENOUS CANNULA
 
   
 
 
 

   
CHECK LIST
• RECIPROCANT SAW FINOCHIETO SEPARATOR
PEACEMAKER WIRE STEEL SURGICAL SUTURE

SUTURES
AORTIC PUNCH PERFUSION CANNULA TOURNIQUETS CLIPS LT 100 AND 200
TABLE ARRANGEMENTS AND
SUPPLIES
TABLE MAY TABLE RESERVE
EXTRACORPOREAL
CIRCULATION
MACHINE
•THE EXTRACORPOREAL CIRCULATION
MACHINE WILL BE IN CHARGE OF
SUPPLYING THE HEART AND LUNGS WHEN
THE HEART GOES INTO A PUMP TO WORK
DIRECTLY ON THE HEART
SURGICAL PROCEDURE
IMPORTANT DATABODY
SURFACE: 2.09
BLOOD FLOW : 5.2
HEPARIN UNITS: 6.65
THE BEGINNING IS GIVEN BY PERFORMING THE EXTRACTION OF THE GRAFT FROM THE
EXTERNAL SAPHENON VEIN OF THE LEFT LEG AND CLOSURE OF BLOOD LEAKS AND
PERMEABILITY IS PERFORMED

THE STERNOTOMY IS BEGINNING ALWAYS PRESERVING

HEMOSTASIS THE STERNAL MEDULLA IS COATED WITH BONE WAX
TO PRESERVE THE HEMOSTASIS OF THE STERNAL AND IN TURN THE
GRAFT OF THE MAMMARY ARTERY IS PREPARED
• THE POINTS OF THE TOBACCO BAG OF THE AORTA ARE
MADE IN THE VENAS CAVA AND THE TOURNIQUETS ARE
PLACED THROUGH THREADS AND LEAVE IT REPAIRED
AND AFTER THIS, AN ARTERIOTOMY AND VENOTOMY
ARE PERFORMED TO PERFORM THE FIXATION OF THE
CORRESPONDING CANNULAS AND FIX THEM

• WHEN THE HEART ENTERS THE PUMP, THE

SAPHENONAL GRAFT IS PLACED. IN THIS CASE, REPAIR
OF THE RIGHT CORONARY ARTERY, THE POSTERIOR
DESCENDING ARTERY, AND THE RIGHT CORONARY
ARTERY ANASTOMOSIS OF THE MAMMARY ARTERY IS
MADE IN

• PERMEABILITY AND ANASTOMOSIS ARE VERIFIED AND

THE HEART OF THE PUMP IS REMOVED AND THE
EXTRACORPOREAL CIRCULATION CANNULAS ARE
REMOVED AND THE PACEMAKER WIRE AND CHEST
TUBE ARE PLACED THE CIRCUMFLEX ARTERY
 BIBLIOGRAPHY
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