Doctor Shadowing in Cardiothoracic Surgery

2) Operation Room clothing: the basic clothing includes the use of top cover, pants, mask, shoe and hair cover. These sterilized clothes are worn by the surgical team and assistants before performing any surgery. Specific aseptic techniques should be followed.

Online reference

3) Surgical disposable mask: a step of the scrubbing into surgery. Wear to avoid the transmission of bacteria from mouth and nose in order to maintain a sterilized environment.

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4) Scrub room: an area where surgeons and the surgical team wash and scrub their fingernails, hands, and forearms through the use of disposable sterile brushes and bactericidal soap. This is a crucial step before starting any surgery in order to reduce the bacterial infection spreading inside the operating room, as well as improving the sterile environment requires in the room.

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5) Operation Room (OR): a sterile room where surgical procedures are performed.

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6) Surgical forceps: a variety of instruments used for surgical procedures to cut, suture, among others.

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7) Surgical sterile station: a sterile station where surgical instruments and materials to be used are placed on. Sterile stations can not be touched by members who have not followed the proper scrubbing procedure.

By Esmarline De León

9) Internal defibrillation pads: depolarizes the myocardium culminating with ventricular fibrillation, arrhythmias. This achieves a normal electrical activity and is used to release large electrical charges in short times. 

By Esmarline De León

13) Doppler flow detector: an ultrasound that examines arteries' blood flow by testing the change in frequency through the use of the Doppler effect. Usually, it is highly used after a cardiovascular surgery is done.

By Esmarline De León

14) Thoracic drainage: its purpose is to remove excess fluid (blood) and air, after a surgical intervention. A tube is set after a perforation from the superficial to the interior part of the chest. Usually, this machine is connected to a suction machine.

By Esmarline De León

15) Electrosurgical unit: a versatile surgical equipment called System 5000 by Conned, which provides the precise energy output needed for surgery. It is known as the most durable electrosurgical generators in the world. Its versatility fits the need of many different surgical areas and medical fields like the following:

• Pulse coag mode: general surgery
• Lap mode: robotic surgery, all minimally invasive procedures
• Fluids Mode: urology, gynecology, arthroscopic procedures
• Pulse cut mode: gastrointestinal (GI)
• Micro Bipolar Mode: neurology, ENT
• Macro Bipolar Mode: general Surgery, endoscopy, urology, gynecology

https://cdn.shopify.com/s/files/1/1046/1086/files/ConMed-System-5000-ESU-Brochure.pdf

16) Ultrasound machine: an advanced ultrasound imaging machine with a variety of acoustic acquisition and processing aspects. It is considered the highest level of premium performance. 

http://www.usa.philips.com/healthcare/solutions/ultrasound/ultrasound-interventional-cardiology

17) Anesthesia workstation: provides a complete reducing process cost with features of fully automated self-test. 

https://www.draeger.com/en-us_us/Hospital/Products/Anaesthesia-Workstations/Anaesthesia-Machines/Apollo

18) Cardiac pulmonary machine: usually known as heart-lung machine. It is an artificial blood pump that assumes the function of the heart and lungs during an open heart surgery, especially when the surgery requires the heart to be still during the operation. 

By Esmarline De León

19) Coagulation timer system: a microprocessor-controlled electrochemical coagulation system that measures blood's coagulation time. It provides a precise clot detection technology. This is instrument is used by perfusionist during heart surgery procedures.

http://www.medtronic.com/us-en/healthcare-professionals/products/cardiovascular/pediatric-perfusions/act-plus-instrument.html

20) Cell tubes: tubes used in the Act Plus microprocessor which has a series of medicament at the bottom of the tube which provides the necessary chemicals for washing the blood and then passing it to the patient.

By Esmarline De León 

21) Temperature machine: a machine used to monitor and control body temperature during surgery. 

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22) Heater machine: equipment used after a surgical procedure, especially after an open heart surgery. The patients' body temperature is increased by blowing the body with heat.  

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23) Pulmonary retractor: a surgical equipment used to open the pericardium during thoracic and cardiovascular surgeries. 

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24) X-ray panel reader: a panel used to read and interpret x-ray images for medical purposes. 

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25) Neosynephrine: a drug that increases heart rate and blood pressure without affecting heart rhythm. It is a vasoconstrictor medication which increases blood pressure. It also stimulates receptors on blood vessels causing vasoconstriction (blood vessels to constrict).

By Esmarline De León

26) Ephedrine: stimulant and medication. In cardiac surgeries is used to increase the blood pressure and the pulse. It is also often used 

By Esmarline De León 

27) Epinephrine: also known as adrenaline. It is a medication, hormone, and neurotransmitter. As a neurotransmitter, it plays a relevant role in the fight-flight response. As a medication, it is used to treat a number of conditions like superficial bleeding, and cardiac arrest.

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28) Sevoflurane: it is a non-flammable inhalational anesthetic for maintenance and induction of general anesthesia.

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29) Heparin: a medication that acts as anticoagulant, preventing extension and formation of clots within the blood. In general it is used as an anticoagulant to avoid blood coagulation when it passes through a non-biological material. It is used in the following conditions:

• Cardiopulmonary bypass
• Atrial fibrillation
• Pulmonary embolism

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30) Protamine sulfate: a medicament used to reverse the effects of heparin. It is used in particular in low molecular weight heparin and heparin overdose.

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32) Cardioplegic solution: a sterile formulation of electrolytes in water. This formulation should only be used after sodium bicarbonate is added, and pH adjustments prior to administration is done. During open heart surgery this solution induces hypothermia.

A mixture of 1000 mL of cardioplegic solution and 10 ml 8.4% sodium bicarbonate injection should be used to adjust pH. The right way to do the procedure is by adding the 8.4% sodium bicarbonate injection to the cardioplegic solution to ensure a pH of 7.8 at room temperature.

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33) 8.4% Sodium bicarbonate injection: a hypertonic solution made of sodium bicarbonate in water. It is a systemic alkalizer and an electrolyte replenisher. The intravenous therapy raises blood pH, reverses the clinical manifestations of acidosis, buffers excess hydrogen ion concentration, and increases plasma bicarbonate. 

By Esmarline De León

34) Furosemide: a diuretic medication. It increases the amount of urine a person makes helping the body get rid of extra water. To do that it decreases the strain on blood vessels and the heart, reducing the risk of strokes, kidney problems and heart attacks, and also lowering high blood pressure. It can also improves trouble breathing. 

35) Sterile water for irrigation: a sterile and hypotonic water, which contains no bacteriostatic or antimicrobial agents, or added buffers. Due to the properties of water and the special treatment made by distillation for its preparation, this water provides a very clear visibility during endoscopic procedures. It has both pharmaceutical and clinical uses. 

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36) Betadine scrub cleaning solution: scrub antimicrobial solution with surfactants applied to the patient (both skin and mucous) prior a surgical procedure.This is the first patients' scrubbing step. This solution contains 7.5% by volume of povidone iodine.

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37) Open heart surgery: a surgery performed in the arteries, valves and muscles of the heart while the chest open. The most common type of open heart surgery done in adults. Commonly performed in coronary artery bypass grafting (CABG). 

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38) Coronary Artery Bypass Graft (CABG): procedure to treat heart disease. A heart bypass is made by grafting either (or both) the saphenous vein or a mammary artery to a blocked coronary artery. The bypass procedure brings fresh blood to the heart with this technique.

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39) Saphenous vein extraction: the longest vein in the body which is typically removed to perform coronary artery bypass (CABG). Femoral artery substitutes the work of the saphenous vein once this one is removed, by supplying enough blood to the leg. 

Online reference

40) Mitral valve surgery: a minimally invasive surgery. This surgery is performed to either replace or repair the mitral valve. The mitral valve is located between two chambers, making sure blood moves forward through the heart: 

1) Left atrium: where blood flows from the lungs to enter the chamber. 

2) Left ventricle: final pumping chamber where blood passes after entering the left atrium. 

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41) Mitral valve replacement: it is an open heart surgery where the damaged valve is replaced with an artificial one. The artificial one can be either a mechanical or bioprosthetic valve. Usually, a heart valve repair is recommended instead of this one depending on the case.

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42) Femoropopliteal bypass: also known as fem-pop bypass. During this procedure diseased or clot blood vessels above or below the knee is bypass to redirected blood through a graft material or a healthy blood vessel that has been transplanted. This will allow blood flow to be constant and complete decreasing the risk of ischemia, inflammation and in many cases amputation. 

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43) Tracheostomy: a medical procedure (temporary or permanent). It is performed to a blocked airway, ventilator support or a need for prolonged respiratory support. To open the restricted airway and enable breathing, a tube is inserted into your windpipe. This will allows air to enter the lung. This procedure is usually referred to as a stoma. 

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44) Carotid endarterectomy (CEA): a surgical procedure that corrects stenosis in the internal or common carotid artery reducing the risk of stroke. 

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49) GORE PROPATEN Vascular Graft: a thromboresistant bioactive graft surface. Specifically designed for vascular procedures of very clinical concern such as the risk of acute thrombotic failure. This prevents the thrombus formation in the luminal surface using the anticoagulant properties of heparin and maintaining bioactivity. 

https://www.goremedical.com/products/propaten

50) Chemical indicator strip: chemical indicators change colors from red to yellow to indicate that instruments have been exposed to Hydrogen Peroxide during processing in Sterrad sterilizer.

52) Carotid artery disease: the two main arteries that carry blood to the head and neck. Plaque formation in this area leads to limit the oxygen-rich blood to flow to the body and tissues. This oxygen limitation leads to stroke. This disease is known as one of the main causes of stroke in USA.

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53) Aortic aneurysm: when part of the artery wall weakens causing an aortic aneurysm. 

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54) Aortic valve stenosis: a condition where the aortic valve narrows. This valve is in charge of making sure blood flows through the heart's lower left ventricle to the aorta. Stenosis difficult cardiac conditions since it prevents the valve from opening properly. 

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55) Cardiac tamponade: also known as a pericardial tamponade. It occurs when fluid in the sac around the heart, called pericardium, accumulates resulting in heart compression. Some causes are aortic rupture, connective tissues disease, cancer, among others.

56) Coronary artery fistulae (CAF): a congenital anomaly that connects a cardiac chamber (or great vessel) and one or more of the coronary arteries.

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57) Myocardial infarction: known as heart attack. In this condition the heart's tissue gets ischemic (part of the muscle can begin to die). Some of the common symptoms are discomfort and chest pain, and it can travel to parts like the neck and jaw. The discomfort feels like a heartburn. Usually, the chest pain lasts minutes on the left side. A heart attack causes cardiac arrest, heart failure, and irregular heartbeat. 

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58) Cardiac arrest: heart electrical problem that happens when the heart stops beating unexpectedly or malfunctions. When an electrical malfunction is present, the heart is unable to pump blood to the tissues, brain, lungs and within seconds the person stops beating or even die if not treated fast.

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59) Heart failure: a chronic condition in which there is a reduced oxygen blood supply due to the heart's inability to pump as well as it should be. In general, the heart can not keep its workload without meeting the body's needs for oxygen and blood. In this disease, the left ventricle gets dilated, affecting the heart muscle. This does supply enough blood through the cells. People with this condition have a very difficult to do simple things like walking or even carrying groceries.

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60) Stroke: occurs when oxygen and nutrients supply to the brain is interrupted. When the carotid artery is obstructed by plaques may cause a stroke due to the limited blood flow.

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61) Atrial fibrillation: an irregular heartbeat made by problems in the heart electrical signal that can lead to stroke, clots or heart failure.

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62) Pulmonary embolism: a blocked artery in the lung, usually a blood clot. These clots can damage the lung. It can be deadly if it is large and stops blood flow to the lung. Quick treatment is required.

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63) Varicose vein: veins are tubes that move oxygen-depleted blood from the tissues to the heart. A varicose vein occurs in people with insufficiency in the circulatory system. 

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64) Deep vein thrombosis (DVT): formation of blood clots n the deep veins, especially in the legs. Some symptoms are swelling and pain. Blood clots block blood flow (pulmonary embolism) when it lodges in the lungs.

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65) Superficial thrombophlebitis: an inflammatory-thrombotic disorder in which a blood clot is developed in the superficial skin. It usually occurs in lower extremities, in particular in Mondor disease (the penis and breast). It can be also be developed in places like the neck or arm. This disease is most of the time benign. Thrombophlebitis progresses if occurs in the saphenous vein. Damage to deep vein leads to recurrent pulmonary embolism, increased risk of death, and leads to chronic deep venous insufficiency. 

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66) Atherosclerosis: a disease where plaques or clots builds up inside the arteries obstructing blood flow. These plaques are made up of calcium, cholesterol, fat among others. It hardens and narrows the arteries limiting the oxygen-rich blood flow to the different organs in your body.

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67) Coronary angiogram: a study used to identify arteries in the body in order to find any cluster in the flow of arteries.

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68) Electrocardiogram (ECG): a study that shows the electrical signal of the blood in different  points of the body. 

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69) The Heart:  a muscular organ that controls the body blood supply. Through the blood vessels such as arteries, veins and capillaries, it pumps blood to tissues and  the body. This blood provides oxygen and nutrients to the body. This muscle is located in between the middle compartment of the chest and the lungs. 

http://www.vhlab.umn.edu/atlas/index.shtml

72) Artery: a blood vessel that delivers oxygen-rich blood from the heart to the tissues.

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73) Vein: veins carry blood to the heart and deoxygenated blood from tissues to the heart. Except in umbilical veins and pulmonary veins. 

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74) Capillary: smallest blood vessel that work in the mircro-irculaiton. 

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75) Femoral artery: main arterial supply to the lower limb. It is a large artery located in the thigh. 

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