Exam 24: Cardiac Surgery

Open commissurotomy of the mitral valve,which is performed for mitral stenosis,is the separation of fused,adherent leaflets of the mitral valve.The nurse assists in placing the patient in the supine position for a median sternotomy.The setup is the same as that described for open-heart procedures,with mitral valve instruments.Select two additional nursing actions that are relevant to the patient with open commissurotomy.

Patients with chronic,severe angina who cannot be revascularized with either coronary bypass surgery or PCI may be appropriate candidates for laser transmyocardial revascularization (TMR).Channels are created in the left ventricular wall with laser energy (e.g.,CO₂,holmium:yttrium-aluminum-garnet [Ho:YAG]).What relevant nursing intervention must accompany this procedure?

Surgery for atrial fibrillation (AF)may also be performed through an open sternotomy or right mini-thoracotomy incisions.By creating small areas of scar tissue in the cardiac muscle,electrical impulses are forced to follow an alternative conduction path or "maze." Select all the statements regarding nursing considerations for the maze procedure that are true.

The blood is oxygenated in the lungs and returns to the left atrium through the pulmonary veins.Where does the blood flow after leaving the left atrium?