Appointments Available: (281)-316-6003

Glossary

A

Anastomosis (Anastomoses – Plural)

A natural communication, direct or indirect, between two blood vessels or other tubular structures. 2. An operative union of two hollow or tubular structures.

Angina Pectoris

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 nitroglycerine (NTG).

Angiographically Significant CAD

Coronary artery disease 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.

Anterior

Front of the body or towards the front of the body.

Anticoagulant

Any agent that inhibits coagulation. (See Heparin and Hirudin.)

Aorta

The large single artery arising from the left ventricle carrying oxygenated blood to the systemic circulation.

Aortic

Of or pertaining to the aorta.

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.

Arrhythmia

Any deviation from the normal pattern of the heartbeat. Kinds of arrhythmias include atrial fibrillation, atrial flutter, heart block, premature atrial contraction and sinus arrhythmia.

Arteriole

Small muscular vessels that are formed from the small branches of arteries; the arterioles then branch to form the capillaries.

Arteriosclerosis

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

Arteriotomy

Any surgical incision into the lumen of an artery, e.g., to remove an embolus.

Artery

A relatively thick-walled, muscular pulsating blood vessel that carries blood away from the heart. With the exception of the pulmonary and umbilical arteries, the arteries convey red or aerated blood to the tissues of the body ending in small branches.

Atherosclerosis

A form of arteriosclerosis in which atheromas containing cholesterol, lipid material and lipophages are formed within the intima and inner media of large and medium-sized arteries.

Atrial

Of, or referring to, the atrium or atria.

Atrial Fibrillation

An atrial arrhythmia characterized by rapid randomized contractions of the atrial myocardium, causing a totally irregular, often rapid ventricular rate.

Atrium

The small antechamber of the heart which receives blood from the lungs and body.

B

Blood Pressure

The pressure exerted by the circulating volume of blood on the walls of the arteries, the veins, and the chambers of the heart. Overall blood pressure is maintained by the complex interaction of the homeostatic mechanisms of the body moderated by the volume.

Blood Volume

The amount of blood circulating throughout the body in the vascular system.

Bolus

A dose of drug or fluid that is injected in the venous system all at once as opposed to over a gradual period of time.

BPG (Bypass Graft)

Aterial, vein or other conduit grafted beyond a vessel obstruction to create new flow through a diversionary channel.

Bradycardia

Slowness of the heartbeat, usually defined (by convention) as a rate under 60 BPM (synonym—brachycardia).

C

Cannula (in CPB)

A flexible tube which can be inserted into a cavity, usually by means of a trocar filling its lumen; after insertion of the cannula, the trocar is withdrawn and the cannula remains as a channel for the transport of fluid.

Cardiac Catheterization

Passage of a catheter into the heart through a blood vessel leading to the heart for the purpose of measuring intra-cardiac pressure abnormalities, obtaining cardiac blood samples, and/or imaging cardiac structures by injection of radio-opaque dye.

Cardiac Index

A measure of cardiac function that accounts for body size. It is calculated by dividing the cardiac output by the body surface area. An average adult’s cardiac index ranges from 2.8-3.6 liters per minute.

Cardiac Mortality

Death due to cardiac cause.

Cardiac Output (CO)

CO is the primary indicator of cardiac function. It is the volume of blood ejected from the left ventricle per minute. CO is calculated by multiplying stroke volume by heart rate. An average adult’s CO is 5.6 liters per minute.

Cardiogenic Shock

Failure to maintain blood supply to the tissues because of inadequate cardiac output, such as may be caused in myocardial infarction.

Cardiomyopathy

A general diagnostic term designating primary myocardial disease.

Cardioplegia

1. Paralysis of the heart. 2. An elective temporary stopping of cardiac activity by injection of chemicals, selective hypothermia, or electrical stimuli.

Cardiopulmonary

Relating to the heart and lungs.

Cardiopulmonary Bypass (CPB)

The procedure that enables the blood to bypass the heart and lungs so that the surgical field is relatively dry and motionless. CPB involves the temporary substitution of a pump oxygenator for the heart and lungs to accomplish this.

Cardiotomy

1. Surgical opening in the heart. 2. Component of extracorporeal circuit serving as a reservoir for blood.

Cardiothrombus

A clot of blood within one of the heart’s chambers.

Cardiovascular (CV)

Relating to the heart and the blood vessels or the circulation.

Carotid Arteries

The pair of blood vessels that arise from the aorta into the cranial cavity and provide the majority of bloodflow to the brain.

Catheter

A hollow, flexible tube that is used to withdraw or instill fluids. The tubes used to deliver cardioplegia solutions are usually considered catheters.

CCU (Coronary Care Unit)

Central Venous Pressure

The pressure in the right atrium, so called because all systemic veins drain into the right atrium.

Cerebral Embolization

Travel of gas or particulate matter through an artery to the brain.

Cerebral Hemorrhage

The result of rupture of sclerosed or diseased blood vessel or aneurysm in the brain. Often associated with high blood pressure.

Cerebral Infarction

Macroscopic area of cerebral necrosis caused by sudden severe reduction in blood flow to the brain. Cerebral infarction is a stroke caused by blood vessel occlusion (as opposed to blood vessel rupture).

Cerebral Ischemia

Insufficient blood flow to the brain due to obstruction of circulation. Prolonged or severe ischemia will cause permanent brain injury (stroke).

Cerebral Perfusion

Blood flow to the brain. Cerebral perfusion is directly related to mean arterial pressure and inversely related to cerebral vascular resistance.

Cerebrovascular Disease

Disease (usually atherosclerosis) of the cervical or intracranial blood vessels.

CHD (Congenital Heart Disease)

Chordae Tendineae

Strands of tendon that anchor the cusps of the mitral and tricuspid valves to the papillary muscles of the ventricles, preventing prolapse of the valves into the atria during ventricular contraction.

Circulation

Movement in regular or circuitous course, as the movement of the blood through the heart and blood vessels. Includes collateral (compensatory), coronary, pulmonary (lesser), and systemic (greater or peripheral).

Coagulate

1. To convert a fluid or a substance in solution into a solid or gel. 2. To clot; to curdle; to change from a liquid to a solid or gel.

Co-morbidity

Concomitant but unrelated pathologic or disease process usually used to indicate coexistence of two or more disease processes.

Congestive Heart Failure (CHF)

Failure of the heart to maintain adequate circulation of blood.

Coronary

Encircling in the manner of a crown; especially to the arteries of the heart, and by extension, to pathologic involvement of them.

Coronary Artery Bypass Graft (CABG)

Vein or artery grafted surgically to permit blood to travel from the aorta 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 Sinus

The opening into the right atrium to which the veins of the left coronary circulation drain.

Coronary Stenosis

Narrowing or constriction of any arteries, orifices or chambers leading into or from the heart.

Coronary Thrombus

Blood clot that obstructs a blood vessel of the heart.

CPK (Creatine Phosphokinase)

An enzyme important in muscle contraction that is elevated in plasma following myocardial infarctions.

CPR (Cardiopulmonary Resuscitation)

Cross-matching

The mixing of a donor’s blood with a potential recipient’s blood to test for compatibility.

Cx (Circumflex Artery [circ])

D

Defibrillation

Termination of atrial or ventricular fibrillation, usually by electric shock.

Diastole

Referring to the period of time during relaxation of the ventricle(s).

Diastolic Pressure

The arterial blood pressure during the diastolic phase of the cardiac cycle.

Distal

1. Situated away from the center of the body, or from the point of origin; specifically, applied to the extremity or distant part of a limb or organ.

Dyspnea

Shortness of breath, a subjective difficulty or distress in breathing, usually associated with disease of the heart or lungs; occurs normally during intense physical exertion or at high altitude.

Dysrhythmia

Disturbance of normal heartbeat rhythm. Any abnormality in the rate, regularity or sequence of cardiac activation.

E

ECHO (Echocardiogram)

Echocardiography

The process of reflecting ultrasound Doppler signals off the heart and surrounding anatomical structures to visualize cardiac activity and structure, and facilitate diagnosis.

Edema

Accumulation of an excessive amount of watery fluid in cells, tissues or serous cavities.

EEG (Electroencephalogram)

A diagnostic test that records the electrical activity of the brain. Electrodes are laced on different locations of the scalp, and the difference between the electrical potential of the two sites is recorded.

Ejection Fraction (EF)

The portion of the end-diastolic volume that is actually ejected (normally about two-thirds).

Electrocardiogram (ECG or EKG)

A graphic representation of the electrical activity of the heart. Also called an ECG or EKG.

Emboli

Mass of undissolved matter in a blood vessel brought there by blood current or flow. Emboli may be solid, liquid or gaseous. Emboli may consist of bits of tissue, tumor cells, fat globules, air bubbles, clumps of bacteria, and foreign bodies.

Endoscopic Vein Harvesting (EVH)

A process in which a section of a vein is taken from one part of the body to repair or replace a diseased blood vessel in another body area. For example, the saphenous vein, located in the leg, may be harvested for use during coronary artery bypass surgery.

Endotracheal Tube

Tube used inside the trachea to provide an airway through the trachea while preventing aspiration of foreign material into the bronchus.

Epiaortic Ultrasound Imaging

Use of ultrasound to determine the location and severity of atherosclerotic disease in the ascending aorta. More sensitive than TEE or manual palpation.

Erythrocyte

A mature red blood cell that contains molecular hemoglobin.

Exercise Tolerance Testing

Stress test; a diagnostic test in which the patient exercises on a treadmill, bicycle, or other equipment while heart activity is monitored by an ECG.

Extubation

Removal of a tube from an organ, structure, or orifice; specifically, removal of the tube after intubation.

F-G

Fibrillation

Involuntary recurrent contraction of a single muscle fiber or of an isolated bundle of nerve fibers. Fibrillation of a chamber of the heart results in inefficient random contraction of that chamber and disruption of the normal sinus rhythm of the heart. Fibrillation is usually described by the part that is contracting abnormally, such as atrial fibrillation or ventricular fibrillation.

Great Vessels

The large arteries and veins arising from the heart and pericardium.

H

Heart Attack (Myocardial Infartction – MI)

Scarring, or death, of the heart muscle due to lack of oxygen. Oxygen-rich blood is blocked by a blood clot in a coronary artery, usually due to plaque-related narrowing of the artery.

Heart Block

An interference with the normal conduction of electric impulses that control activity of the heart muscle. Heart block usually is defined as to the location of the block and the type.

Heart Sound

A normal noise produced within the heart during the cardiac cycle that can be heard over the pericardium and may reveal abnormalities in cardiac structure or function.

Hemodynamic Instability

Instability of the blood pressure.

Hemodynamics

The study of the movements of the blood and of the forces concerned therein.

Hemoglobin

The red pigmented complex protein found in the red blood cells that functions to carry oxygen and carbon dioxide.

Hemostasis

The cessation of bleeding through normal coagulation or by surgical procedure.

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.

Hypertension

Characterized by increased or excessive blood pressure. Hypertension is the most powerful and potent risk factor for stroke.

Hyperthermia

Temperature above normal.

Hypoperfusion

Decreased blood flow to an organ or tissue such as in shock.

Hypotension

Characeterized by decreased or lower than normal blood pressure. Excessive and prolonged blood pressure reductions may lead to watershed cerebral infarction.

Hypothermia

A body temperature significantly below 98.6°F (37°C).

I-L

Induction

The period from the start of anesthesia to the establishment of a depth of anesthesia adequate for a surgical procedure.

Inferior

Below another structure.

Inotropic

Influencing the contractility of muscular tissue.

Intermediate

Between two structures.

Intra-Aortic Balloon Pump (IABP)

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 obstructive atherosclerotic plaque.

Intubation

Insertion of a tubular device into a canal, hollow organ, or cavity.

Ischemia

Deficiency of blood to a tissue or organ in the body due to obstruction or constriction of arteries, thereby threatening the viability of that tissue or organ. In cardiac surgery ischemia is of concern mostly with regard to the heart (myocardial ischemia).

Left Atrium

The upper left cardiac chamber that receives blood from the pulmonary veins and delivers blood to the left ventricle.

LAD (Left Anterior Descending Coronary Artery).

Lateral

1. On the side. 2. Farther from the median or midsagittal plane. 3. To the side.

LIMA (Left Internal Mammary Artery)

Lumen

The space within an artery, vein, intestine, or tube.

M

Magnetic Resonance Imaging (MRI)

High-resolution imaging technique that is performed without use of radiation or injection of contrast medium. Valuable for obtaining images of the heart, large blood vessels, brain and soft tissues.

Mammary

Region surrounding nipple and breast.

Medial

Relating to the middle or center, nearer to the median or midsagittal plane.

Minimally Invasive Bypass Surgery

A less invasive procedure than traditional bypass surgery to create a path for blood to flow around a clogged artery usually performed without use of the heart-lung machine.

Mitral

Referring to the bicuspid valve separating the left atrium and ventricle to prevent back flow into the atrium during ventricular systole.

Multivessel Disease

Disease in two or more of the coronary arteries.

Myocardial Infarction (MI) (Heart Attack)

Damage to the heart muscle caused by occlusion of one or more of the coronary arteries.

Acute MI—An acute process of myocardial ischemia with sufficient severity and duration to result in permanent myocardial damage.

Myocardial Ischemia

The deficiency of blood supply to the heart due to the obstruction or constriction of coronary arteries.

Myocardium

The muscular wall of the heart located between the inner endocardial layer and the outer epicardial layer.

N-O

Nitroglycerine (NTG)

Used as a vasodilator, especially in angina pectoris.

Obtuse Marginal

Branches of the circumflex coronary artery.

Off-Pump Coronary Artery Bypass Surgery (OPCAB)

A surgical procedure that does not use the heart-lung machine, or “pump”, to perform coronary artery bypass surgery. The heart is slowed down with medications, and a heart stabilizer is used to isolate and minimize the motion of the diseased artery.

Oxygenator

The portion of the CPB perfusion apparatus that subserves the functions of the patient’s natural lungs during periods of extracorporeal circulation. It is a device that mechanically oxygenates venous blood extracorporeally.

P

Patent

Open, unobstructed, intact.

PDA (Posterior Descending Artery)

Percutaneous Transluminal Coronary Angioplasty (PTCA)

Commonly referred to as “balloon angioplasty”. This procedure is a less invasive interventional coronary procedure in which a balloon is used to displace arterial blockages.

Perfusion

1.The act of pouring over or through, especially the passage of fluid through the vessels of the heart. The fluid that is passed is called the perfusate. 2. Flowing over or through. 3. Blood flow through the organs and tissues of the body.

Perfusion Balloon Angioplasty

A variation of PTCA in which a catheter is inserted in the artery that permits blood flow during balloon inflation.

Perfusionist

A specialist trained to operate the heart-lung machine

Pericardial

Located intermedial to the pleural cavities which contain the heart.

Pericardium

The tough non-elastic membrane surrounding the heart that attaches to the great vessels and other anatomical structures in the mediastinum.

Peripheral

Occurring away from the center.

Peripheral Vascular Disease

Disease of the arteries and veins of the extremities (e.g., atherosclerosis), which interefere with adequate blood flow to or from the extremities.

Plasma

The cellular, colorless liquid portion of the blood.

Pleural

Relating to lungs.

Post-MI angina

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

Posterior

Back of the body or towards the back of the body.

Preload

The degree of myocardial stretch before contraction at the end of diastole. The ventricular end-diastolic pressure and volume reflect this parameter.

Pressure

Stress or force exerted on a body, as by tension, weight, or pulling.

Protocol (CPB)

A prescribed (surgeon-specific) procedure for initiating, maintaining, and discontinuing CPB. While maintaing certain fundamental clinical parameters, protocols vary from surgeon to surgeon, hospital to hospital.

Proximal

1. Nearest the trunk or the point of origin, said of part of a limb, of an artery or a nerve, etc., so situated. 2. Nearest to head or source, nearer to the attachment of a limb to the trunk.

Pump

The blood propulsion device included in the extracorporeal circuit to replace the left ventricular function.

R

Right Atrium

The upper right cardiac chamber that receives blood from the venae cavae and delivers blood to the right ventricle.

RCA (Right Coronary Artery)

Recumbent

Lying down.

Re-stenosis

The recurrence of a stenosis.

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 or PTCA is performed.

RIMA (Right Internal Mammary Artery)

S

SA Node (Sino-Atrial Node)

Saphenous Vein

A vein located in the leg, that is commonly used as a conduit to perform coronary artery bypass grafts.

Sinus Node

Bundle of excitatory tissue found in the right atrium that functions as the pacemaker of the heart.

Stenosis

1. A blockage or narrowing in the lumen of a vessel, thereby compromising optimal flow of fluid or blood. 2. A narrowing or blockage of a coronary artery.

Sternal

1. Relating to the sternum or breastbone. 2. Region between two mammary regions.

Stroke

Brain injury caused by abrupt disruption of blood flow to the brain. Most frequently caused by arterial occlusion (due to thrombosis or embolism) or to intracranial hemorrhage (rupture of blood vessel or aneurysm).

Stroke volume

The amount of blood ejected by the ventricle during a ventricular contraction.

Subcutaneous

Beneath the skin.

Superficial

Toward or on the surface of the body.

Superior

Above another structure.

Supine

Lying on the back.

Systole

Referring to the period of time during contraction of the ventricle(s).

Systolic Pressure

The arterial blood pressure during the systolic phase of the cardiac cycle.

T-U

TEE (Transesophageal Echocardiography)

A Doppler echocardiographic transducer is inserted in the esophagus to visualize the lungs, heart and great vessels.

Thrombus, pl. (Thrombi)

A clot in the cardiovascular systems formed during life from constituents of blood; it may be occlusive or attached to the vessel or heart wall without obstructing the lumen (mural thrombus).

Trendelenburg Position

Position in which the patient’s head is low and the body and legs are on an elevated and inclined plane.

Tricuspid Valve

The valve between the right atrium and the right ventricle.

Trocar

An instrument for withdrawing fluid from a cavity. It consists of a metal tube (cannula) into which fits an obturator with a sharp three-cornered tip, which is withdrawn after the instrument has been pushed into the cavity. The name trocar is usually applied to the obturator alone, the entire instrument being designated trocar and cannula.

Unstable 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

V Fib (Ventricular Fibrillation)

V Tach (Ventricular Tachycardia)

Valve

A membranous fold in a canal or passage, which prevents the reflux of the contents passing through it.

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 body.

Vasodilate

The arterioles increase in diameter allowing more blood flow.

Vein

Vessel carrying dark red (unaerated) blood to the heart, except for the pulmonary vein — which carries oxygenated blood.

Vein Harvesting

A procedure, in which, a section of a vein is taken from one part of the body to replace or replace a diseased blood vessel in another body area. The most common vein harvested for bypass surgery is the saphenous vein (in the leg).

Vena Cava (Venae Cavae – Plural)

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.

Ventricle

A small cavity or chamber, as in the brain or heart.

Right Ventricle—The lower chamber of the right side of the heart which pumps venous blood through the pulmonary trunk and arteries to the capillaries of the lung.

Left Ventricle—The lower chamber of the left side of the heart which pumps arterial blood through the aorta for distribution to the peripheral tissues.

Ventricular Fibrillation

An arrhythmia characterized by fibrillary contractions of the ventricular muscle due to rapid repetitive excitation of myocardial fibers without coordinated contraction of the ventricle.

Texas Surgical Associates