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CH11 Valves

The Manual of Clinical Perfusion

QuestionAnswer
Who performed the first artificial valve replacement in 1952? Charles Hufnagel
What type of valve was the one developed by Albert Star and Lowell Edwards? a ball and cage valve
When was the Starr-Edwards ball and cage valve used successfully? 1960
What two types are today's valves? Mechanical and bioprosthetic
What two designs are mechanical valves? tilting disk valves and double tilting half-disk (bileaflet)
What is the life expectancy of mechanical valves? Greater than 20 years
While a longer life span is an advantage of mechanical valves, what is a marked disadvantage? Mechanical valves require anti-coagulation medication
What is a coumadin and how does is work coumadin (Warfarin) is a vitamin K antagonist and interferes with the production of vitamin K dependent factors
What are the vitamin K dependent factors? 2, 7, 9, and 10
What two types of bioprosthetic valves are available? Animal, usually porcine (heterographs) Human (homografts)
What percentage of patients will require a new homograft within 15 years? 10-20%
What is a common complication seen with valves? Infection
What is the most accurate method to evaluate cardiac valvular function? Measure pressure gradients across the valve
What type of pressure is seen with mitral stenosis? High atrial pressure with slow fall early in diastole
What type of pressure is seen with tricuspid stenosis? High atrial pressure with slow fall early in diastole
What type of pressure is seen with mitral insufficiency? Atrial systolic increases during ventricular systole
What type of pressure is seen with tricuspid insuffiency? Atrial systolic increases during ventricular systole
What type of pressure is seen with aortic stenosis? A slow-rising aortic pulse pressure
What type of pressure is seen with aortic insufficiency? A collapsing aortic diastolic pressure
Aortic valve area 2.6-3.5 sq cm
Aortic valve flow 250ml/SEP/sec
Mitral area 4-6 sq cm
Mitral valve flow 150/DFP/sec
What is a common cause of mitral stenosis? rheumatic fever
When would a replacement occur over a commissurotomy for MV stenosis? If the leaflets are calcified and the valve not pliable
What effects does mitral insufficiency have on the LV? LV dilatation and hypertrophy
What is the correction for MV prolapse? annuloplasty
What is the common congenital cause of AV stenosis? bicuspid valve
LA enlargement, diminished compliance, dyspnea, CHF, and right sided heart failure result from mitral stenosis or insufficiency? MV stenosis
An overworked left ventricle, lower output, lung congestion, diminished pulses and murmur is found in aortic or mitral stenosis? AV stenosis
Cannulation strategy for MV surgery bicaval
Cannulation strategy for AV surgery two-stage
What special cardioplegia considerations occur during AV surgery? once the aorta is opened, retrograde or ostial must be given
What are the three leaflets of the tricuspid? anterior, posterior and septal
Which tricuspid leaflet is the largest? anterior
Which tricuspid leaflet is the smallest? posterior
What valve failure can cause subsequent tricuspid insufficiency? MV disease, leading to increased right heart pressures
What cannulation strategy is used when opening the right atrium? Bicaval
What is the source of the three cusps of the pulmonic valve? the lining of the PA
Left heart failure, MV obstruction, and pulmonary vascular disease can lead to what pathophysiology of the PV? pulmonic regurgitation
What is associated with pulmonic regurgitation in newborns? A VSD
Created by: pumpchicks