Valvular HD - Surgery Flashcards

1
Q

What valves are most commonly operated on?

A

The aortic and mitral in adults.
All equal in kids

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2
Q

What is rheumatic fever?

A

A relapsing illness occuring due to a streptococcal infection.
Commonly causes progressive Mitral & aortic valve fibrosis, skin and joint manifestations.
Treated with aspirin & bed rest

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3
Q

What organisms commonly cause endocarditis & associated valve damage?

A

Step Viridans
Staph Aureus

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4
Q

What kind of endocarditis is most curable?

A

Native Valve endocarditis is 90% curable with antibiotics (PVE is only 50%)
Strep Viridans is much more curable than Staph Aureus

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5
Q

In a case of Endocarditis what would indicate we should intervene surgically, instead of just use antibiotics?

A

IF the valvular regurgitation is severe
Vegetations are Large
Persistant Pyrexia
Progressive Renal Faiure

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6
Q

What do we give post operatively for endocarditis?

A

Antibiotics IV for 6weeks

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7
Q

When would we give replacement surgery for aortic stenosis, regurgitation and mitral stenosis, regurgitation?

A

AS - When Severe
AR - Severe, especially with LV dilatation (the entire LV will be filled with contrast in one diastole during aortography)
MS - If MVA is <1.5cm2 on an ECHO
MR - If severe MR (i.e. if systolic blood flow is reversed in the pulmonary veins on an ECHO)

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8
Q

How does a cadiopulmonary bypass work?

A

IT drains blood from the RA to the Ascending aorta. It requires induced hypothermia & systemic anticoagulation.
It artificially oxygenates and warms the blood before returning it to the aorta

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9
Q

Why would we choose a biological valve or mechanical valve?

A

Bio Valve - Valve wears out after 15 years.
Mech valve - Needs warfarin for life

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10
Q

What is the max time a CPB machine can be used?

A

12 hours

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11
Q

What is a common complication of open cardiac surgery?

A

Air embolisms.

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