Interventional / Intraop

Question 1

TAVR low implantation complications

Answer 1

Paravalvular regurgitation
MV disruption
CHB

Question 2

Underexpanded TAVR complications

Answer 2

Paravalvular regurg
Prosthetic regurg
Decreased durability

Question 3

Seimquantitative Parameters for TAVR paravalvular regurgitation

Answer 3

Jet width at its origin (% LVOT diameter)
PHT
Descending aortic diastolic flow reversal
Circumferential extent of paravalvular regurgitation

Question 4

TAVR paravalvular Jet width at origin

Answer 4

Mild 5-15%
Moderate 30-45%
Severe >60%

Question 5

TAVR paravalvular PHT

Answer 5

Mild > 500
Mod 200-500
Severe < 200

Question 6

TAVR paravalvular descending aorta diastolic flow reversal

Answer 6

Mild - absent or brief
Moderate - intermediate
Severe - holodiastolic

Question 7

TAVR

Circumferential extent of paravalvular regurgitation

Answer 7

Mild <10%
Mod 10-29%
Severe >= 30%

Question 8

TAVR paravalvular

RVol

Answer 8

Mild < 15
Mod 30-45
Severe > 60

Question 9

TAVR paravalvular RF

Answer 9

Mild < 15%
Mod 30-40%
Severe > 50%

Question 10

TAVR paravalvular ERO

Answer 10

Mild < 0.05
Mod 0.10-0.20
Severe > 0.30

Question 11

Ideal TMVR segment

Answer 11

P2

Question 12

Ideal TMVR calcification

Answer 12

None

Question 13

Ideal TMVR MVA

Answer 13

> 4 cm2

may attempt 3.5-4cm2

Question 14

Ideal TMVR MV gradient

Answer 14

<4 mm Hg

Question 15

Ideal TMVR flail width

Answer 15

<15 mm

Question 16

Ideal TMVR flail gap

Answer 16

<10 mm

Question 17

Flail width

Answer 17

Width along scallop

Question 18

Flail gap

Answer 18

Distance between anterior and posterior leaflets

Question 19

Suboptimal TMVR anatomy

Answer 19

Prior endocarditis
Rupture / perforation
Bulky MAC
Small baseline MVA

Question 20

TMVR complications

Answer 20

Device embolization rare
Partial clip detachment 2%
MS 0.5%
Tamponade 2%
Injury to atrial septum repair

Question 21

Percutaneous paravalvular regurgitation repair complications

Answer 21

Prosthetic leaflet impingement (tilting disc)
Device embolization
Coronary obstruction (aortic)
Stroke / TIA
Pericardial effusion

Question 22

TEE sizing for LAAO

Answer 22

Measure at every 45 degrees
Measure osmium and depth in each view
Use largest diameter, usually at 135 degrees

Question 23

LAAO complications

Answer 23

Effusion / tamponade 1.3%
Device embolization 1.3%
Stroke 0.7%

Question 24

MV repair leading to LV and RV dysfunction

Answer 24

Pre-op LV dysfunction unmasked
Air down coronaries
Lcx artery issues
New MI

Question 25

TV repair rec when undergoing MV surgery

Answer 25

Annulus >= 3.5-4.0 cm

Question 26

MV scallops 4 chamber view

Answer 26

anterior and posterior leaflet

Question 27

MV scallops commissural view 60'

Answer 27

3 medial - 2 middle - 1 lateral

Question 28

3D echo surgeon's view MV scallops

Answer 28

A1 / P1 lateral A2 / P2 middle A3 / P3 medial

Question 29

MR jet not going in expect direction based on anatomy

Answer 29

Cleft like indentation

Question 30

Intraop air embolization coronary territory

Answer 30

RCA

Question 31

TEE for LVAD placement indication

Answer 31

Exclusion of AR

Question 32

Most specific criteria for severe MR

Answer 32

ROA >= 0.4 mm2 | VC >= 7 mm

Question 33

Underfilled LV and LV volumes / EF

Answer 33

Decreased EDV, ESV | Increased EF

Question 34

Most common transient abnormality after placement of stented bioprosthesis

Answer 34

Small periprosthetic regurgitation

Question 35

Complication of MV repair when LV small and hyperdynamic

Answer 35

SAM

Question 36

EF on CPB

Answer 36

May be higher or lower

Question 37

Preferred TEE view for LV apex

Answer 37

Transgastric long axis of LV

Question 38

TEE aorta blind spot

Answer 38

Mid ascending aorta | Caused by trachea between aorta and esophagus

Question 39

MR caused by AR

Answer 39

Perforation of leaflet by AR jet

Question 40

Intervalvular fibrosa

Answer 40

Posterior part of AV annulus Anterior part of MV annulus Septal side of TV annulus Solid structure to which AV attached anteriorly, MV attached posteriorly

Question 41

Risk for coronary obstruction with TAVR

Answer 41

Height of left main <10 mm above annulus | Female sex

Question 42

Ideal TMVR coaptation length

Answer 42

>= 2 mm

Question 43

Ideal TMVR coaptation depth

Answer 43

<= 11mm

Question 44

Complications of LARIAT device

Answer 44

Access complications Pericarditis, pericardial effusion Unexplained sudden death Late stroke

Question 45

Successful alcohol septal ablation

Answer 45

reduction of LVOT gradient >=50%

Question 46

Can't use LARIAT with this type of LAA

Answer 46

Chicken wing