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Thoracic 

Operations

TERMS to KNOW

Ablation: procedure designed to restore a normal heart rhythm, often used for atrial fibrillation or similar dysrhythmia. 

 

ACE inhibitor: short for Angiotensin-Converting-Enzyme inhibitor. Medication that relaxes arteries and causes a lowering of blood pressure. 

 

ACS: short for Acute Coronary Syndrome. A set of signs and symptoms related to impaired coronary blood flow and myocardial damage. 

 

Acute: a disease or condition that is recent in onset or has a short duration. 

 

Acute MI: short for Acute Myocardial Infarction. A new heart attack.  

 

Ad lib: short for ad libitum, a Latin phrase meaning “as you desire.” 

 

AED: short for Automated External Defibrillator. Portable electrical device that 

delivers an electric shock to convert certain life-threatening ventricular dysrhythmias to a normal heart rhythm. Designed to be used by a layperson without medical training and often found at public places like a museum or library or sporting venue.

 

Aerobic exercise: physical exercise involving rhythmic, continuous motions for a sustained period of time, designed to raise the heart rate. The term “aerobics” was coined by Dr. Kenneth Cooper in his book Aerobics, first published in 1968. 

 

A-fib: short for Atrial Fibrillation. 

AICD: short for Automated Implantable Cardioverter-Defibrillator. A medical device placed beneath the skin, capable of detecting and treating several abnormal heart rhythms. 

Analgesic: medication used to reduce pain. 

 

Anastomosis: a surgical connection made between two structures, such as blood vessels. 

 

Anemia: condition of a low level of red blood cells in the blood. 

 

Aneurysm: an enlarged portion of a blood vessel. Can also occur in the heart. Typically the wall of an aneurysm is thinner than normal and bulges out. Because it is thinner, an aneurysm is more likely to tear or rupture than a normal artery. 

 

Angina pectoris: discomfort that occurs because of impaired blood flow and oxygen delivery to the heart muscle. Angina classically begins with exertion and resolves with rest. 

 

Angiogram: a movie-like sequence of pictures produced by x-rays showing blood vessels filled by contrast dye. 

 

Angioplasty: a procedure in which a balloon is inflated inside an artery to forcefully open a blockage. The balloon pushes plaque against the walls of the artery and also enlarges the artery slightly. 

 

Anticoagulant: A medication which reduces the clotting capacity of the blood. Commonly called a blood thinner, although anticoagulants do not usually affect the viscosity of blood to an appreciable extent.  

 

Antiplatelet agent: a medication that reduces the activation or “stickiness” of platelets and helps platelets not to clump together as much. 

 

Aorta: the main artery carrying blood from the heart to the tissues of the body. The aorta is the largest artery in the body. 

 

Aortic Insufficiency: abbreviated AI; synonymous with aortic regurgitation. Involves leaking of blood in reverse direction back into the heart during diastole, when the aortic valve should be closed, thus forcing blood only to flow away from the heart, except for the blood that flows into the coronary arteries.

 

Arrhythmia: abnormal rhythm of the heart; synonymous with the term dysrhythmia. 

 

Arteriosclerosis: “hardening of the arteries.” Disease of arteries involving loss of elasticity, which tends to become more common with advancing age. 

 

Ascending aorta: the first portion of the aorta, which begins at the aortic annulus and ends at the aortic arch. 

 

Asymptomatic: not having or causing symptoms. 

 

Asystole: cessation of the electrical activity of the heart. 

 

Atherectomy: a procedure designed to cut through hard blockages in an artery, using a rotating blade, much like a tiny Roto-Rooter. Performed by an Interventional Cardiologist, although the procedure is not commonly performed. 

 

Atherosclerosis: disease of arteries involving build-up of fatty deposits and plaque. 

 

Atrial fibrillation: aka afib; an abnormal heart rhythm involving rapid and chaotic electrical activity in the atrial chambers of the heart.

 

Atrial Septal Defect: a defect in the inter-atrial septum. Much like a PFO but larger and will often require closure. 

 

Atrium: chamber which receives blood and channels it to a ventricle. The right atrium receives blood from the IVC and SVC and channels it to the right ventricle. The left atrium receives blood from the pulmonary veins and channels it to the left ventricle. From Latin root atria meaning central court.

 

Auscultation: process of listening to internal organs of the body, usually with a stethoscope.

 

AV node: a special collection of cells which transmit electrical impulses from the atria to the ventricles. 

 

AVR: short for Aortic Valve Replacement. Operation involving removal of a diseased aortic valve and insertion of a new valve. A SAVR is a Surgical AVR and a TAVR is a Transcatheter AVR. 

 

BAV: short for Balloon Aortic Valvuloplasty. A procedure performed percutaneously where a balloon is inflated inside the aortic valve to forcefully open it. Can be used to treat aortic stenosis but has a temporary effect. 

 

Beta-blocker: a medication which reduces the activity of epinephrine by binding to Beta receptors of cells of the myocardium, blood vessels and sympathetic nervous system. A beta-blocker lowers the blood pressure and heart rate. A common example is metoprolol. 

 

Bicuspid Aortic Valve: an abnormal aortic valve which has only two moving parts (leaflets) instead of the usual three. The most common congenital abnormality of the heart, which occurs in 2% of the population.

 

BMI: stands for Body Mass Index. A metric that reflects a person’s body weight (mass) adjusted for height. Calculated by dividing a person’s weight (in kg) by the person’s height (in meters) squared. A normal BMI is considered 20-25 kg/m2, overweight 25-30 kg/m2 and obese >30 kg/m2. 

 

Board-Certified: designation of a physician who has demonstrated mastery of knowledge and skill in a field of medicine or surgery, as determined by a national Board. Board-certification is voluntary and not a legal requirement for practicing medicine or surgery in the USA; however, hospitals may require physicians to maintain Board-certification in order to practice at their facility. The American Board of Thoracic Surgery provides certification for cardiac surgeons. I have been Board-certified since 2012. I would strongly recommend a patient confirm his or her surgeon is Board-certified prior to operation. 

 

Brachytherapy: technique in which a (tiny) radiation source is placed within a coronary artery, typically to treat in-stent restenosis. Brachytherapy does not have a role in the treatment of patients at my program. 

 

Bradycardia: a heart rate that is slow, generally less than 60 beats per minute, 

or a rate that is slower than expected for a patient’s age, condition or activity level. 

 

Bruit: pronounced BRU-EE; a sound made by turbulent blood flow within a blood vessel, possibly due to blockage. May be heard in the carotid arteries. 

 

Bundle of His: specialized muscle cells in the interventricular septum which transmit electrical signals from the AV node to the ventricles. Discovered by Dr, Wilhelm His (pronounced hiss) in 1893.

 

Bundle Branch Block: a disorder of the electrical signaling in the heart in which signals traveling through the left or right bundle branches is impaired; this results in one ventricle contracting before the other. 

 

CABG: pronounced CABBAGE, aka Coronary Artery Bypass Grafting. Operation designed to provide additional pathways for blood to flow to the myocardium. 

 

Calcium-channel blocker: medication which slows the passage of calcium into muscle cells in the blood vessels and heart, which lowers blood pressure. 

 

Capillaries: tiny blood vessels within tissues which link arteries and veins and allow for exchange of oxygen and carbon dioxide. 

 

Cardiac: fancy medical word for having to do with the heart.

 

Cardiac arrest: cessation of motion of the heart. 

 

Cardiac catheterization: medical procedure where a small catheter is guided from an artery in the groin or wrist into the arteries of the heart. 

 

Cardiac enzymes: chemicals present in heart muscle cells which do not normally circulate in the bloodstream. Injury to the heart muscle cells results in release of cardiac enzymes, and the enzyme levels become elevated in the blood. 

 

Cardiac Output: the amount of blood which circulates in one minute, usually around 5 liters for an adult. If the heart is severely weakened and the EF is low, cardiac output may be reduced. If the cardiac output is less than what the body’s tissues need, the condition is known as heart failure.  

 

Cardiac rehab: exercise and support program designed to help patients recover after heart surgery, similar to going to a gym to work with a private trainer. But this trainer knows what you can and cannot do after surgery. Typically done 3 days per week for 12 weeks. 

 

Cardiogenic shock: inadequate blood flow to body organs due to sudden impairment in heart function, often due to heart attack. Has a high risk of death.  

 

Cardiologist: a doctor who specializes in caring for the heart.

 

Cardiomegaly: an enlarged heart. The most common cause of cardiomegaly is dilated cardiomyopathy. 

 

Cardiomyopathy: from Greek, literal translation: heart muscle suffering. A disorder involving impaired function of the heart.

 

Cardioversion: a procedure designed to convert an abnormal heart rhythm to a normal rhythm using an electrical shock. 

 

Catheter: a small tube, usually made of plastic, inserted into a part of the body. 

 

Chest tube: a plastic tube which drains fluid, blood or air from the chest, into a collection chamber. At least one chest tube is inserted as part of every heart surgery, so that blood does not accumulate around the heart after operation. The tube is removed in the patient’s room once it is not needed anymore. 

 

Circumflex Artery: coronary artery arising from the Left Main, serving the left side and part of the back of the heart. 

 

Claudication: pain, discomfort or tiredness of the legs which occurs with walking and resolves with rest. May indicate blockages in the arteries of the legs.  

 

Code brown: slang term used when a patient did not make it to the bathroom in time. 

 

Collateral arteries: small pathways which connect arteries when one of the arteries is occluded (completely blocked).

 

Conduit: the blood vessel used to provide a new pathway for blood flow with bypass surgery. 

 

Congenital: a condition present at birth. A congenital heart defect is an abnormality of the heart present at birth. The most common congenital heart defect is a Bicuspid Aortic Valve.  

 

Congestive heart failure: aka CHF. A condition in which the pumping of the heart is inadequate, resulting in congestion of the lungs with blood. 

 

COPD: short for Chronic Obstructive Pulmonary Disease. A lung disease, most commonly caused by smoking cigarettes, characterized by poor air flow and shortness of breath. 

 

Coronary artery: from Latin root corona meaning “crown.” An artery that supplies blood to the heart muscle. 

 

Coronary sinus: the main vein that drains blood from the heart muscle. 

 

CPAP: short for Continuous Positive Airway Pressure. A form of ventilation where a machine maintains air pressure inside the patient’s airway above atmospheric pressure. Commonly used to treat obstructive sleep apnea. 

 

CPR: short for CardioPulmonary Resuscitation. Used when a person’s heart has stopped beating. Involves chest compressions to compress the heart from the outside and move blood, to keep the person alive until more advanced help can be delivered or the heart begins to beat again on its own. 

 

CT scan: short for Computed Tomography, aka CAT scan (Computed Axial Tomography). Produces images of internal anatomy based on a series of closely spaced x-rays which are compiled by computer. Can be done with contrast given into a vein or swallowed by mouth or without any contrast. Contrast helps anatomic details be more accurately seen.   

 

CVA: short for CerebroVascular Accident = stroke. Results from inadequate blood flow to the brain, equivalent to a heart attack. May be due to impaired blood flow (ischemic stroke) or due to bleeding (hemorrhagic stroke). 

 

CXR: short for Chest X-Ray. An X-ray showing structures in the chest and may show certain pathology such as fluid around the lungs (pleural effusion).  

 

Cyanosis: a bluish coloration of skin or tissues due to reduced oxygen content of the blood. 

 

DAPT: short for Dual Anti-Platelet Therapy. Using two medicines to inhibit platelet function, in order to avoid thrombosis inside a fresh stent. Often Aspirin and Plavix are used. 

 

Debridement: removal of diseased tissue or foreign material by surgical removal. 

 

Defibrillator: a device that delivers an electric shock in order to help restore a normal heart rhythm; see AED.

 

DES: short for Drug-Eluting Stent. A small metal tube designed to hold a blockage in a coronary artery open. The stent is coated with a polymer that releases tiny amounts of a drug to help prevent overgrowth of cells within the stent. 

 

Diabetes mellitus: a disease involving excess levels of sugar in the bloodstream, also associated with excess levels of sugar passed in the urine. 

 

Diaphoresis: fancy medical word for excessive sweating. 

 

Diastole: the time period during which the heart muscle relaxes. This corresponds to the diastolic blood pressure, when the arteries in the body also relax slightly. 

 

Diastolic blood pressure: the lowest blood pressure measured in the arteries, which occurs when the heart is in the relaxation or filling phase of the cardiac cycle. A common BP reading is 120/80 mmHg; in this case, 80mmHg is the diastolic pressure. 

 

Dilated cardiomyopathy: a condition in which the heart is enlarged, or dilated, and has impaired function. 

 

Diuretic: a medication which causes an increase in the production and passage of urine. Lasix is a common diuretic (not to be confused with LASIK, which is a procedure on the eyes). 

 

DNR: short for Do Not Resuscitate. An order that lets hospital personnel know if the patient’s heart stops, they should not attempt to make it beat again - i.e.,  CPR will not be performed. In general, if present prior to operation, a DNR order must be suspended for heart surgery, since the heart will be stopped intentionally. 

 

DVT: short for Deep Vein Thrombosis. A blood clot which forms in a vein deep in the leg, often due to reduced physical activity or immobilization. May result in pain or swelling in the leg or may not cause obvious symptoms. A DVT can move to the lungs, causing a Pulmonary Embolism. 

 

Dysrhythmia: abnormal heart beat; aka arrhythmia. 

 

Dyspnea: fancy medical word for shortness of breath. Often phrased as dyspnea on exertion = shortness of breath when physically active. 

 

ECG: short for ElectroCardioGram; see EKG.

 

Echocardiogram: an ultrasound of the heart. First named “ultrasound cardiography” by echo pioneer Dr. Inge Edler. Provides images of the heart in motion, including the ventricular muscle and the heart valves. May be a TTE which is through the skin or TEE which is down the esophagus. 

ECMO: short for ExtraCorporeal Membrane Oxygenation, pronounced ECK-mo. Complex machine that works like the heart-lung machine to pump blood and to put oxygen in the blood, designed to function outside the Operating Room. Used when the heart and lungs are unable to support life but only on a temporary basis. The technology is hindered by complications such as bleeding and infection but can be life-saving for certain patients. Rarely used (rarely needed) in association with heart bypass.  

 

Edema: pronounced eh-DEE-ma. Swelling of body tissues due to accumulation of fluid. Commonly affects the feet and ankles. 

 

EEG: short for ElectroEncephaloGram. Measures and records electrical activity of the brain. Not used commonly for heart surgery patients, and not to be confused with EKG or TEE. 

 

Ejection Fraction: aka EF. The fraction of blood ejected from the heart with each contraction, stated as a percentage. A normal EF is 60%. Could possibly refer to either the Left Ventricular EF (LVEF) or the Right Ventricular EF (RVEF). If not specified, EF is assumed to mean LVEF.

 

EKG: short for ElectroKardiogramm. A tracing of the electric potentials of the heart, created using several leads in contact with the skin. 

 

Embolism: lodging of a piece of material inside a blood vessel. Often, the material is a blood clot. Though rare, an embolism to a coronary artery could cause a heart attack. An embolism to the brain could cause a stroke. During heart surgery, it is possible to encounter an air embolism, where air obstructs a blood vessel. 

 

EMS: short for Emergency Medical Services. Ambulance or paramedic service. An EMT is an Emergency Medical Technician and provides care as part of EMS. A paramedic has additional training and expertise and also provides care as part of EMS. 

 

Endocarditis: inflammation of the inner layer of the heart chambers, the endocardium. 

 

Endocardium: the innermost layer of cells, or lining, within the heart. 

 

Endothelium: single layer of cells which line all blood vessels in the body. The endothelial layer of the arteries and veins is in direct contact with blood. 

 

Epicardium: a thin film of cells which covers the heart tissues. 

 

Epinephrine: aka adrenaline. Hormone made by the adrenal gland. Epinephrine has many actions in many tissues in the body. 

 

Erythema: fancy medical word for redness. 

 

ET Tube: short for EndoTracheal Tube. A plastic tube placed through the mouth into the trachea to allow for breathing during a general anesthetic or to facilitate use of a mechanical ventilator (breathing machine). To “intubate” a patient means to place an ET tube. 

 

EVH: short for Endoscopic Vein Harvest. A method to extract a vein out of the leg for use in CABG, using a video camera and small incisions. 

 

Exertion: physical use of energy, resulting in motion. 

 

Extubate: to remove a patient’s breathing tube. 

 

Femoral artery: large artery that courses near the groin, providing blood to the leg.   

 

Fibrillation: a cardiac dysrhythmia characterized by disorderly, chaotic quivering of myocardium. Can affect the atria or ventricles. Atrial fibrillation is not generally life-threatening and may resolve on its own, but ventricular fibrillation is usually fatal if not promptly corrected. A defibrillator is a device designed to detect ventricular fibrillation and deliver an electrical impulse in order to stop the fibrillation, but the device will not take action due to atrial fibrillation. 

 

Fibrosis: fancy medical word for scarring. 

 

Flutter: a cardiac dysrhythmia characterized by rapid but abbreviated contractions of the heart. Flutter is usually slightly more organized than fibrillation. 

 

Foley catheter: plastic tube inserted through the urethra into the bladder. Usually used during long operations or when a patient cannot get out of bed to urinate. 

 

H&P: short for History and Physical. The parts of a doctor-patient interaction which include information about patient symptoms and examination. 

 

Harvest: to move a blood vessel out of its normal location so that it can be used as a bypass graft. 

 

HDL: short for High Density Lipoprotein. Molecule which transports cholesterol away from cells in the body to the liver. 

Heart attack: aka myocardial infarction. Refers to damage to heart muscle cells due to inadequate blood flow and delivery of oxygen through the coronary arteries. 

 

Heart block: interruption of the conduction of electrical signals from the atria to the ventricles. 

 

Heart-lung machine: complex machine used during heart surgery which pumps the blood (assuming the function of the heart)  and allows gas exchange (puts oxygen in the blood, assuming the function of the lungs). Used for On-Pump CABG and valve operations. It is controlled by a perfusionist. 

 

Hematoma: a collection of blood in tissues, like a three-dimensional bruise.

 

Hemorrhage: fancy medical word for bleeding.  

 

Heparin: a commonly-used anticoagulant, or so-called blood thinner. Used in high dosage to prevent blood clotting inside the heart-lung machine and used in small doses to prevent blood clots in hospitalized patients. Heparin is not absorbed by the bowels so there is no pill form and it must be given by injection. Discovered in 1916 from liver tissue of dogs, most heparin now comes from cow lungs or pig intestines. Yes, you cannot make this stuff up (double pun - there is no known way to synthesize heparin)!  

 

Holter monitor: portable device invented by physicist Norman Holter, used to monitor a patient’s heart rate and rhythm for 24 hours or more. 

 

Hormone: a chemical signal that acts on a distant tissue or organ in the body.  

 

Hypercholesterolemia: elevated levels of cholesterol in the bloodstream. Commonly treated by diet modification and/or statin medications. 

 

Hypertension: aka high blood pressure. A condition characterized by an elevated force of blood pushing against the body’s arterial walls. Commonly treated by diet, exercise, and anti-hypertensive medications.  

 

Hypertrophic Obstructive Cardiomyopathy: abbreviated as HOCM, pronounced HO-cum. Aka IHSS or Idiopathic Hypertrophic Subaortic Stenosis. A disorder involving overgrowth of the muscle of the septum between the ventricles; the muscle bulges and interferes with pumping blood out of the heart.  

 

Hypertrophy: fancy medical word for excessive thickness of the heart muscle. The heart muscle is thicker not because new cells have been added, rather the muscle cells become larger. 

 

Hypotension: low blood pressure. 

Hypoxia: low oxygen levels in body tissues. 

 

IABP: short for Intra-Aortic Balloon Pump. Device inserted through an artery in the groin which inflates inside the aorta. It helps improve flow in the coronary arteries. Not used much anymore but can be useful for cases of severe weakness of the heart after heart surgery; an Impella is more commonly used for this contingency.

 

Iatrogenic: caused by a physician or other health-care provider. 

 

ICD: short for Implantable Cardioverter Defibrillator; see AICD. 

 

ICU: short for Intensive Care Unit. Area of hospital where constant care, close supervision and advanced life support technologies are used. Sometimes called MICU for Medical ICU and SICU for Surgical ICU. 

 

Idiopathic: has no known cause or the cause has not been identified. 

 

IHSS: short for Idiopathic Hypertrophic Subaortic Stenosis; see Hypertrophic Obstructive Cardiomyopathy. 

 

Ileus: decreased propulsion of the intestines, which is often associated with bloating and distention of the abdomen. In layman’s terms, it is the equivalent of the bowels going to sleep so that foodstuffs (stool) are not pushed downstream. Can be due to severe illness or as a response to major surgery or for other factors. Most CABG patients do not have a bowel movement until POD 3 or 4, but this is likely a combination of constipation and decreased intake rather than ileus per se. If a patient experiences nausea, vomiting and abdominal pain and distention, the diagnosis may be ileus. Typically with a post-op ileus, “tincture of time” is the only therapy needed; in severe cases, an NG tube may be placed to decompress the stomach.  

 

Impella: brand name for a medical device which works like a pump to help move blood out of the heart, when the heart is severely weak. An Impella is usually placed through the skin (percutaneously) and for temporary support for several days or perhaps a week or two. 

 

Incise: to make a cut with a surgical instrument. 

 

Infarction: death (necrosis) of cells due to inadequate blood flow.

 

Infective endocarditis: infection of the inner lining of the heart, the endocardium, often involving the heart valves. Can be caused by bacteria which travel through the bloodstream from another site of infection and stick to the endocardium. 

Inflammation: complex biologic response of the body to infection, damage or irritation. Characterized by redness, warmth, swelling, pain and loss of function of the affected body part. 

 

Inpatient: fancy medical word used to describe a test or procedure performed with a patient admitted to the hospital. 

 

Insufficiency: aka regurgitation. Refers to inadequate closing of a heart valve and blood moving backward through the valve; see Aortic Insufficiency and Mitral Regurgitation. 

 

Intensivist: a medical doctor specializing in intensive care, which deals with taking care of patients in an ICU. Not to be confused with Internist. 

 

Intern: a medical doctor training in his or her first year after graduating medical school. If you are in the hospital and an intern is taking care of you, run! Just kidding. Every doctor has to learn somewhere. Interns are overseen by attending physicians. An intern is also known as a first-year Resident or R1. 

 

Internist: a medical doctor who specializes in the field of Internal Medicine. Like a pediatrician for adults, but not called an Adultist. Not to be confused with an Intern.  

 

Intubate: to insert a breathing tube, through the mouth and into the trachea. 

 

IS: short for Incentive Spirometry. Device used to strengthen a patient’s breathing after operation. Often has a gauge that moves up to help the patient focus his or her effort. Air is breathed in through the spirometer, as opposed to a PEP device, where air is blown out. 

 

Ischemia: a restriction or impairment in blood supply to tissues, involving insufficient oxygen delivery needed for cellular metabolism.

 

Iso-CABG: term describing a heart operation where bypasses are performed and no other major change to the heart is made, such as valve replacement. The iso-CABG operation is one of the most heavily studied and scrutinized operations in the history of surgery. 

 

IV: short for IntraVenous. Refers to something inside a vein. In common usage, an “IV” is a small catheter inside a vein, used to give medications and to draw blood for lab tests. 

 

IVC: short for Inferior Vena Cava. The large vein which drains blood from the lower body to the right atrium of the heart.

 

IVUS: short for IntraVascular UltraSound. A medical technology which can be used as part of a cardiac cath to assess arteries for blockages using sound waves. Often only used if it is difficult to tell how severe a blockage is, in which case IVUS can help clarify the severity. 

LAD: short for Left Anterior Descending, pronounced “L.A.D.” The coronary artery on the front of the heart. Colloquially called the “widowmaker” when acutely occluded.  

 

LDL: short for Low Density Lipoprotein. Molecule which transports cholesterol to body cells. It is desirable to have a low LDL level in the blood, as a low level is associated with reduced risk of CAD. 

 

Ligate: to tie up or close off with a suture. 

 

LIMA: short for Left Internal Mammary Artery, pronounced LEE-ma. Aka LITA, Left Internal Thoracic Artery, though most people use the term LIMA. An artery located beside the breastbone on the left side, commonly used for bypass surgery. 

 

Lumen: the open area inside a hollow tube, as in an artery. 

 

LVH: short for Left Ventricular Hypertrophy. Condition where the myocardial muscle cells of the left ventricle become hypertrophied, or bigger in volume. Not exactly a disease but more of a response to high demand, such as high blood pressure, which is causing the myocardium to work more than usual.   

 

MAZE: a form of ablation done as part of a heart operation, designed to treat atrial fibrillation. 

 

Median sternotomy: classic incision to access the heart and aorta, which cuts through the middle of the breastbone from top to bottom. 

 

MI: short for Myocardial Infarction; see Heart Attack. 

 

MID-CAB: short for Minimally Invasive Direct Coronary Artery Bypass. A heart operation using a small incision in the left chest, which avoids sternotomy and provides a bypass graft to a blocked coronary artery. Usually performed Off-Pump and connects the LIMA to LAD.  

 

Mitral Prolapse: aka Mitral Valve Prolapse. Involves movement of one or both mitral valve leaflets out of the normal plane (excessive motion). May or may not cause leakage of the mitral valve and may or may not need to be fixed. 

 

Mitral Regurgitation: abbreviated MR, aka mitral insufficiency; for some reason mitral insufficiency is not used often and “MR” is much more commonly used. Involves leakage of blood in reverse direction back through the mitral valve into the left atrium when the left ventricle contracts.

Mitral Stenosis: condition involving stiffness and narrowing of the mitral valve, where the mitral valve cannot open easily, impairing the motion of blood through it. The most common cause of mitral stenosis is Rheumatic Heart Disease. 

 

mmHg: short for millimeters of Mercury. Typical units of measurement for blood pressure in the human body. A blood pressure of 120/80 is more accurately 120 mmHg/80 mmHg. 

 

MRI: short for Magnetic Resonance Imaging. Imaging technology which produces images of internal anatomy based on the differences in how tissues respond to a magnetic field. Not commonly used in association with CABG. The stainless steel wires used to secure the sternal bone in position after median sternotomy are safe for an MRI. 

 

Murmur: sound related to the motion of blood through a heart valve. May or may not signify a disease or problem with the heart.

 

MVR: short for Mitral Valve Replacement. Operation to remove a diseased mitral valve and place a new valve. 

 

Myocardial Infarction: death (necrosis) of heart muscle cells due to inadequate blood flow. 

 

Myocardium: aka heart muscle. Specialized involuntary muscle cells which make up the bulk of tissue of the walls of the heart and allow its pumping function.  

 

Myxoma: a connective tissue tumor which classically arises in the left atrium of the heart. Can cause a stroke if a piece of the tumor breaks off (which would be an embolism) or can interfere with the function of a heart valve. Treatment is removal. A myxoma is not cancerous. 

 

Narcotic: psychoactive compound derived from opium; in a medical sense, used for pain control. Examples include morphine, codeine and several derivatives. 

 

Necrosis: a form of cell death by auto-digestion, in response to severe cellular injury.

 

NG tube: short for NasoGastric tube. A tube that goes through the nose and down into the stomach, usually used to drain fluid out of the stomach. Not typically needed for heart surgery patients.  

 

Nitrate: a medication which uses nitric oxide to cause widening (dilation) of blood vessels. Nitroglycerin is a commonly used nitrate.  

Normal Saline: fancy medical term for water with a small amount of salt in it, commonly used for IV fluid. 

 

Normal Sinus Rhythm: a heart rhythm with temporal regularity, caused by electrical signals coming from a normally-functioning SA node (the sinus node). 

 

NP: short for Nurse Practitioner. A medical professional who cares for patients semi-independently, under the direction of a physician. 

 

NPO: short for Nil Per Os, meaning nothing by mouth. The patient is not allowed to eat or drink when NPO. Often patients are NPO for several hours prior to operation. This is so that the stomach has time to empty prior to the patient lying flat, so that fluid does not reflux up from the stomach into the mouth and then down into the lungs. 

 

NSTEMI: short for Non-ST Elevation Myocardial Infarction. A heart attack that does not involve elevation of the ST segments of an EKG. Usually diagnosed by a rise in cardiac enzymes. 

 

O2 Sat: short for Oxygen Saturation. The percent of hemoglobin in the blood bound to oxygen. Usually measured with a pulse oximeter, at the fingertip. The highest possible reading is 100% and 95% or higher is normal. 

 

Obesity: medical condition characterized by accumulation of excess body fat to the point that negative health effects occur. A person is usually considered obese if his/her BMI is >30 kg/m2. By this metric, over 40% of adult Americans are obese, according to the CDC.

 

Occlusion: complete blockage of a blood vessel, resulting in stoppage of blood flow.

 

Off-Pump Bypass: CABG operation performed with the heart beating, without use of the heart-lung machine (the “pump”). 

 

OPCAB: short for Off-Pump Coronary Artery Bypass. 

 

Open-heart: term used to describe surgery involving opening the chest in order to operate on the heart. The heart itself may or may not be opened. I do not myself use this term because I find it misleading. 

 

OR: short for Operating Room. Specialized area designed to allow sterile surgical procedures.  

 

Outpatient: fancy medical word used to describe a test or procedure performed without admitting the patient to the hospital. 

PA: Short for Physician’s Assistant. Medical professional trained to assist a surgeon with operations and care of patients. I have a PA assisting me with all operations. 

 

Pacemaker: medical device surgically placed beneath the skin that provides an electrical signal to the heart, causing the heart to beat at a set rate. 

 

Palpitations: an awareness of the heart beat, often associated with the onset or presence of a cardiac dysrhythmia. 

 

Patent: pronounced PAY-tent; medical term describing a structure being open. If an artery is patent, it is open and not occluded. 

 

PCI: short for Percutaneous Coronary Intervention. A procedure performed on the coronary arteries through the skin. Procedures include stent placement, atherectomy, and brachytherapy. Since atherectomy and brachytherapy are relatively uncommon, in common usage, PCI usually refers to insertion of a coronary stent. 

 

PCP: short for Primary Care Physician. Your general doctor. 

 

PFO: short for Patent Foramen Ovale. A remnant of the foramen ovale, which is  found in normal fetal development and usually closes at birth. Can be associated with rare forms of stroke but in the absence of symptoms, a PFO does not require treatment. 

 

Percutaneous: from Latin, meaning through the skin. Refers to a medical procedure performed with puncture of the skin with a needle, rather than an open exposure by cutting the skin with a scalpel. 

 

Pericardial effusion: an accumulation of fluid within the pericardial sac, around the heart. If a pericardial effusion enlarges quickly, the pressure inside the pericardial space will increase and the heart can begin to struggle, a condition known as cardiac tamponade.  

 

Pericarditis: inflammation of the pericardium. 

 

Pericardium: the sac of connective tissue encasing the heart. The pericardium is thin but strong, often described as similar in strength to a burlap sack. A thin film of fluid lubricates the heart inside the pericardium. 

 

PFTs: short for Pulmonary Function Tests. Designed to gauge a person’s lung capacity; involves blowing air out into a machine.  

 

Plasma: the liquid part of the blood. 

Pleural effusion: accumulation of fluid around the lung; that is, outside of the lung but within the rib cage.

 

PE: short for Pulmonary Embolism. A blood clot lodged in one or more of the pulmonary arteries. Often originates as a DVT in a leg vein, which moves through the right atrium and tricuspid valve and right ventricle into the pulmonary artery. Can be life-threatening, if blood has difficulty leaving the right ventricle and getting into the lungs.  

 

PEP: short for Positive Expiratory Pressure device. A plastic device - looks like a kazoo - which helps build strength of breathing after surgery. 

 

Pneumothorax: abnormal collection of air outside the lung and inside the ribcage. A tension pneumothorax has high pressure and can be dangerous or even fatal. 

 

POD: short for Post-Op Day. POD1 is the day after surgery. Most patients can expect to go home on POD4 or POD5 after bypass surgery. 

 

PRN: short for Pro Re Nata, a Latin phrase meaning as the need arises. Used with medications that are taken as needed, such as most pain medicine. In contrast to scheduled medications, which are taken at a given time, regardless of perceived need. 

 

Prognosis: medical prediction of the outcome or likely result of a disease or condition. 

 

Prophylaxis: fancy medical word for prevention. 

 

Protamine: a medication derived from salmon sperm that neutralizes the anticoagulant effect of heparin. 

 

PTCA: short for Percutaneous Transluminal Coronary Angioplasty. In common use, usually shortened to simply “angioplasty;” see Angioplasty. 

 

Pulmonary Hypertension: elevated blood pressure within the arteries of the lungs, which creates additional mechanical work for the right ventricle. 

 

Pulse Ox: short for Pulse Oximeter. Medical device which estimates the oxygen saturation of the hemoglobin in the blood using light absorption through the skin, typically at the fingertip. 

 

Pump head: slang term for temporary confusion occurring after heart surgery where the heart-lung machine was used. This term is not used much anymore due to its vagueness.  

PVC: short for Premature Ventricular Contraction. An “early” heartbeat which originates from Purkinje fibers in the ventricles rather than the SA node. May feel like a “skipped beat” to a patient. An occasional PVC is not unusual and is not usually dangerous. 

 

Radial artery: one of two arteries in the forearm, which provides blood to the hand. Can be used as conduit for CABG, especially in young patients. 

 

RCA: short for Right Coronary Artery. One of the three major coronary arteries. 

 

Regurgitation: abnormal flow of blood in reverse direction through a heart valve. Synonymous with Insufficiency. Severity of Regurgitation is usually described as None, Trace, Mild, Moderate or Severe. Severe regurgitation will typically cause symptoms. 

 

Renal: fancy medical word for relating to the kidneys. 

 

Resection: fancy medical word for surgical removal of tissue. 

 

Resident: a physician who is training in a specialized field of medicine or surgery. Term came about because trainees worked so much they lived at the hospital. 

 

Resolve: to go away, to become normal again. 

 

Re-stenosis: narrowing of a blood vessel or stent which was previously opened through intervention. 

 

Rheumatic Heart Disease: inflammatory disease of the heart caused by rheumatic fever, which results from untreated Streptococcus pyogenes (Strep throat). Can cause dysfunction and scarring of heart valves. Not seen much in the US now due to widespread use of antibiotics.

 

RVR: short for Rapid Ventricular Response. Usually used to describe atrial fibrillation with a HR >100 beats per minute. 

 

SA node: short for SinoAtrial node. The collection of cells in the heart that creates an electrical impulse to cause the heartbeat. The SA node sets the heart rate under normal conditions, influenced by the vagus nerve and sympathetic nerve fibers, as well as hormones.   

 

Saphenous vein: one of the large veins in the leg commonly used in CABG. More specifically called the Greater Saphenous Vein. 

 

SAVR: short for Surgical Aortic Valve Replacement. An operation that involves an open incision and the heart-lung machine to replace an aortic valve, in contrast to TAVR. 

Sepsis: a life-threatening condition related to the body’s response to a severe infection.

 

Septum: the muscular wall separating left and right chambers of the heart. The inter-atrial septum separates the left and right atria and the inter-ventricular septum separates the left and right ventricles. A PFO is a (relatively) normal defect present in the inter-atrial septum in ~15% of adults but there are no normal defects in the inter-ventricular septum. 

 

Serum: the liquid portion of the blood without the proteins involved in blood clotting.   

 

Shock: a condition in which the blood flow to body organs is inadequate. Often signified by low blood pressure - often severely low - which does not improve with IV fluids.  

 

Shunt: a tube that connects two previously unconnected parts of the body, allowing fluid to flow. Not to be confused with stent. 

 

Sick Sinus Syndrome: a collection of complex cardiac dysrhythmias that originate from dysfunction of the SA node. Often the patient will go back and forth between high heart rates and low heart rates. 

 

Single-vessel disease: CAD which involves only one of the coronary arteries. 

 

Skin-to-skin: term used in surgery to describe the time from the first cut of the skin with the scalpel to the final closure of skin with suture. It is the purest account of the duration of operative technique, whereas the patient may be in the OR longer for preparation prior to the incision and then stabilization after closure. 

 

SOB: short for Shortness of Breath. 

 

Sodium: chemical element with symbol Na, found in table salt. Important in regulation of cellular processes. 

 

Spasm: sudden, involuntary contraction of muscle. 

 

Stable angina: chest pain or discomfort that starts with exertion and stops with rest. 

 

Statin: medication used to lower cholesterol levels by inhibiting the enzyme HMG-coA reductase, which is needed for the body to make cholesterol. 

STEMI: short for ST-Elevation Myocardial Infarction. A heart attack which causes changes to the ST segments on an EKG. Considered the most dangerous type of heart attack. 

 

Stenosis: narrowing of an opening, such as a blood vessel or heart valve. 

 

Stent: a tube used to keep a passageway open. A coronary stent is a metal tube used to keep a coronary artery open after balloon angioplasty. 

 

Sternal wires: stainless steel wires used to bring the two halves of the breastbone back together securely after median sternotomy. 

 

Sternum: the breastbone. 

 

Stroke: damage to brain cells due to reduced blood flow and oxygen delivery. May be due to a blockage in an artery (ischemic stroke) or due to bleeding (hemorrhagic stroke). 

 

Sublingual: a method of medication absorption below the tongue. Nitroglycerin is often given in a sublingual form. 

 

SVC: short for Superior Vena Cava. The large vein which drains blood from the upper body (head, arms) into the right atrium of the heart. 

 

Swan-Ganz Catheter: catheter placed percutaneously in a vein, usually in the neck, which can measure blood flow and pressure in chambers of the heart. 
 

Syncope: medical term for loss of consciousness or fainting, generally due to insufficient blood flow to the brain. 

 

Systole: the time period during which the heart muscle contracts. 

 

Systolic Blood Pressure: the highest blood pressure measured in the arteries, which occurs when the heart is in the contraction phase of the cardiac cycle. A common BP reading is 120/80 mmHg; in this case, 120mmHg is the systolic pressure. 

 

Tachycardia: a heart rate that is faster than normal. In general, a resting heart rate over 100 beats per minute is considered tachycardic. 

 

Tamponade: aka cardiac tamponade, pronounced TAM-pon-odd. A condition in which a pericardial effusion increases the pressure within the pericardial space, impairing function of the heart. Tamponade can be deadly if not promptly relieved by drainage of the pericardial effusion. 

 

Target: the location on a coronary artery where a bypass graft is attached. 

TAVR: short for Transcatheter Aortic Valve Replacement. A procedure which replaces a stenotic aortic valve without an open incision or the heart-lung machine. Often a trans-femoral approach is used, with access being made through the femoral artery in the groin.  

 

TECAB: short for Totally Endoscopic Coronary Artery Bypass. Method of CABG involving use of the robot to harvest conduit and complete the anastomosis. 

 

Telemetry: system used to monitor a patient’s heart rate from a remote location, once a patient is out of the ICU. 

 

Tension pneumothorax: a collection of air outside the lung, with increased pressure such that heart function is affected. Can be life-threatening if the air pocket is not relieved, which is done with insertion of a chest tube. 

 

Thoracic: having to do with the chest, the thorax. 

 

Thrill: vibration of the skin which can be felt overlying the turbulent flow of blood. 

 

Thrombosis: formation of a blood clot within a blood vessel, obstructing blood flow through the vessel. Can occur within a stent, which would be called in-stent thrombosis. 

 

TIA: short for Transient Ischemic Attack. Neurologic dysfunction caused by temporary impairment in blood flow, which lasts less than an hour. A TIA involves no permanent damage to the brain. 

 

Triple-vessel disease: CAD involving all three major coronary arteries. 

 

Troponin: enzyme found in heart muscle cells which if detected in the blood indicates muscle damage and thus heart attack. 

 

Type and Cross: short for Type and Crossmatch. Process used to determine a patient’s blood type and compatibility in preparation for blood transfusion.   

 

Unstable angina: chest pain or discomfort at rest, or more severe or frequent symptoms compared to previous. Unstable angina is more concerning for potential danger than stable angina. 

 

UTI: short for Urinary Tract Infection. Layterm is “bladder infection.” Can be a problem for patients after surgery if a Foley catheter is kept in the bladder for several days. 

 

Vagus nerve: cranial nerve X (ten), which is part of the autonomic nervous system, providing fibers to the heart, lungs, and digestive organs. It “wanders” throughout the torso. 

Ventilator: a machine that pushes air into the lungs through a tube in the mouth (the ET tube), to allow a patient to breathe while under an anesthetic or while unable to breathe adequately for him- or herself.

 

VSD: short for Ventricular Septal Defect. A hole in the wall of muscle between the ventricles (inter-ventricular septum). Could be a congenital defect or a complication of MI. In adults, a VSD will usually need to be closed. 

 

Widowmaker: slang term for a heart attack involving the LAD. 


Xiphoid: cartilage located at the bottom of the breastbone (sternum).