Prosthetic heart valves

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Echo Flashcards on Prosthetic heart valves, created by ecmarchese on 20/02/2014.
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Flashcards by ecmarchese, updated more than 1 year ago
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Created by ecmarchese about 10 years ago
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Resource summary

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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