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Flashcards in Mitral Valves Deck (32):
0

Whi regards to MV segments, which one is medial and which is lateral?

Medial= 3
Lateral = 1

1

Which MV leaflet has larger surface area but occupies only 1/3 of annulus?

Anterior

2

Which MV leaflet has smaller surface area but occupies 2/3 of the annulus?

Posterior leaflet

3

What to look for opinion cath tracings for MS?

At diastole, LAP>>LVP

4

What valve area, mean gradient, and systolic PAP defines moderate MS?

MVA: 1-1.5cm
Mean grad : 5-10
PAP: 30-50

5

What stage of MS is asymptomatic, MVA150ms, severe LAE?

C

6

What stage of MS is symptomatic, MVA150ms, severe LAE?

D

7

What does it mean when opening snap in MS is early?

MS is severe

8

If a pt with MS develops Pulm HTN, what is their median survival in years?

<3 y

9

Besides MV replacement, what is a surgery for MS?

Mitral commissurotomy

10

Wilkins score for MS gives 4 points to each of the following:

- leaflet thickening
- leaflet calcification
- leaflet mobility
- subvalvular thickening

11

What MVA is considered severe MS?

<1.5cm

12

According to 2014 guidelines, if a pt has Progressive MS (MVA>1.5cm, PHT<150ms) but has sxs with no other cause, what is best next step?

See if PCWP >25 with exercise, and if so, you can do PMBC (IIb)

13

What ERO and Regurgitant Volume define severe MR?

ERO> 40
RVol> 60

14

With normal LA and LV, can MR be severe?

No

15

Causes of MR

Rupture (Pap m, chordal, leaflet)
Endocarditis
MVP
ischemia
Rheumatic

16

In acute MR, how loud will murmur be?

Soft

17

What stage if MR is asymptomatic, severe (jet area >40% LA, RVol>60cc, ERO>.4, LAE, PHTN) and EF>60%/LVESD<40mm?

C1

18

What stage if MR is asymptomatic, severe (jet area >40% LA, RVol>60cc, ERO>.4, LAE, PHTN) and EF40mm?

C2

19

What stage of MR is severe, sxs (dec ET)?

D

20

Type I MR mech

Annular dilatation

21

Type II MR Mech

Excessive leaflet motion (MVP, flail)

22

Type IIIa and IIIb MR mech

IIIa- restricted leaflets in diastole
IIIb- restrict leaflets in systole

23

In type II MR, which way is jet directed?

Away from abnormal leaflet

24

Example of type IIIb MR

Ischemic

25

What variable on echo determines the natural history CV event rate associated with MR?

ERO

26

Class I indication for stage C2 MR?

MV surgery

27

What is the treatment algorithm if pt has severe MR (vena contracta >.7, ERO>40, RVol>60) and pt has sxs (Stage D)?

See if EF> 30%, if yes, then MV Surgery (I)
If not, IIb

28

What is treatment algorithm for a patient with severe MR (vena contracta >.7, ERO>40, RVol>60), asymptomatic , LVEF 30-69%, LVESD> 40mm?

MV Surgery (I)

29

If pt has severe MR (vena contracta >.7, ERO>40, RVol>60) and new AF or PASP> 50 (stage C1), what is treatment algorithm ?

MV Repair if likelihood of success is >95% with low mortality (IIa)

30

Treatment algorithm for severe MR, sxs, EF<30% and chordal preservation unlikely

Medical Rx

31

for MR, is repair or emplacement preferable?

Repair