565843
Description
Flashcards by ecmarchese, updated more than 1 year ago
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Created by ecmarchese
over 11 years ago
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| Question | Answer |
| What are two different types of grafts? | Bio prosthetic valves, mechanical valves |
| What are 3 types of bio prosthetic valves? | Auto-graft, homografts, heterografts |
| What are 3 types of mechanical valves? | Ball and cage, tilting disc, bileaflet tilting disc |
| Self to self (graft) | Auto graft |
| What two ways can you do a Auto- graft? | Utilize the PV annulus and trunk and transfer to the AOV position, Fascia Lata |
| What is it called when a band that is placed on the PV? | Ross procedure |
| Can a Fascia Lata also be used as a bioprosthetic valve? | Yes |
| Are fascia Lata commonly used? | No |
| This is a type of graft that is made from thigh muscle covering | Fascia Lata |
| This type of graft is used from human to human | Homograft |
| Where do we get a homograft valve from? | Human Cadaver donors |
| Are the durability of the homograft vales as comparable to the porcine and bovine tissue valves? | Yes |
| This is a valve that goes from animal to human? | heterograft |
| What type of graft uses pigs trileaflet AOV? | Porcine |
| What are two types of heterografts? | porcine, bovine |
| Can porcine valves be stented or unstented? | Yes |
| What are 3 other names for a procine graft? | Hancock, carpenter edwards, intact |
| This graft utilizes a cows pericardium and prepares a trileaflet valve mounted on stents and sewing ring? | Bovine |
| What are some common names for Bovine? | Carpenter-Edwards, lonescu-Shiley |
| Is a Lonescu-Shiley graft still used in the US? | No |
| List some complications of a Bioprosthetic valve? | Calcification/ degeneration, Thrombus, Infective Endocarditis, Regurgitation, Perivalvular leak, Dehiscence, abnormalities of the valve annulus |
| Are all valves inherently stenotic? | Yes |
| What does the stenotic degree depend on? | Type, Size, Shape, site |
| What should you use to calculate the level of stenosis? | Valve area and pressure gradients |
| These are commonly found trapped on stents or leaflets, and can cause a total obstruction or stenosis? | Thrombus |
| Are thrombus common on Bioprosthetic valves? | No |
| Is it common to find regurgitation, and what is considered normal? | Yes, a small jet is considered normal |
| Leaking around the bioprosthetic valve | Perivalvular Leak |
| Why can there be leaking around a bioprosthetic valve? | Usually due to gaps in the sewing or sutures |
| What is it called when there is a rocking of the valve, and why does it occur? | Dehiscence, due to the sewing of the valve loosening up |
| What does a Dehiscence generally cause? | The sewing to break, thus causing a perivalvular leak |
| What are 3 types of Mechanical Valves? | Ball and Cage, Tilting Disc, Bileaflet tilting disc |
| This mechanical valve is a ball within a cage | Ball and cage |
| What is the most common brand of ball and cage valve? | Starr-Edwards |
| True/ Fase: It is possible for a ball and cage valve to function for 20 yrs? | True |
| This mechanical valve is a single tilting disc that creates a major and minor orifice | Tilting Disc |
| What is a common brand name for a tilting disc valve, and what are some other brands? | Bjork Shiley (common), Metronic Hall, Wada-Cutter, Lillehei Kaster |
| Are Bjork Shiley valves still used in the US? Why? | No, due to a problem with strut fracture |
| This mechanical valve is two discs creating 3 orifices? | Bileaflet tilting disc |
| What is a benefit of a bileaflet titling disc? | Promotes Central Flow |
| What is the least Stenotic mechanical valve? | Bileaflet tilting disc |
| What is the most common brands for a bileaflet tilting disc? | St. Jude |
| List some complications of a mechanical Valve? | All valves are inherently stenotic, Thrombus, Pannus, Infective endocarditis, Regurgitation, Dehiscence, perivalvular leak, ring abscess, mechanical failure, hemolysis |
| A fibrous ingrowth of tissue that can lead to regurgitation and stenosis? | Pannus |
| What does a Pannus result in? | Leaflets are unable to open/ close correctly |
| What is the etiology of mechanical/ Bioprosthetic valves? | Valvular Stenosis, valvular Reguritation, Native valve Endocarditis, Aortic Dissection, Valve Repairs with valvular rings |
| What are some common names of MV valve repairs? | Carpentier Rings, Duran rings |
| What pts are likely to recieve a Mechanical valve? | Children and yound adults, pts with renal failure and small valves, pts requiring aortic root replacement due to aortic dissection |
| Why are women who are in child bearing years not given mechanical valves? | They want to avoid being put on blood thinners |
| What pts are likely to recieve a Bioprosthetic valve? | elderly pts where long term durability is less important, when you don't want anticoagulation, and when there is an increased risk for thromboembolism |
| What do you do when you are evaluating a Bioprosthetic valve? | Evaluate leaflet mobility and thickness, evaluate LV function, |
| True/ False: A TEE is not useful when evaluating for vegetations and thrombi | False |
| List some complications you want to rule out when evaluating a Bioprosthetic valve? | Calcification, Degeneration, Stenosis, Thrombus, Infective Endocarditis, regurgitation, Perivalvular leak, Dehiscence, Annulus abnormalities |
| When you are looking at a mechnical valve in echo, what do you evaluate for? | evaluate disc motion, rule out possible complications |
| Why is 2D evaluation of a mechanical valve limited? | Artifact/ Shadowing |
| What complications can you have with a mechanical valve? | Pannus growth, mechanical failure, and (same as bioprosthetic complication) |
| What is a good way to distinguish between mechanical and prosthetic valves? | Artifact |
| This is a highly refelctive artifact that creates bright lines shining down from the valve | Reverberations |
| What is m-mode used for when looking at a replaced valve? | Evaluating poppet/ disc motion |
| What do you use doppler for when evaluating a replaced valve? | Regurgitation |
| What are some treatments for valve replacements? | Serial echoes to evaluate valve, replace valve, and pts with mechanical valves must take anticoagulation medicine |
| What is a type of anticoagulation medicine? | Coumadin |
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