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From Flashcardlet > Prosthetic Valves > Flashcards

Prosthetic Valves Flashcards

1
Q

What are the basic things to consider when choosing a valve?

A 
hemodynamics
thrombogenicity
durability
noise
technical implantation difficulty
age of patient
medical history
valve position and size
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2
Q

What are hemodynamic factors of prosthetic valves that are expected

A

they will all have a little stenosis and leak a little bit (insufficiency)

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3
Q

How long do mechanical valves typically last?

A

forever

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4
Q

Which type of valves last 10-15 years?

A

biprosthetic

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5
Q

What is the tendency of the valve to throw a clot?

A

thrombogenicity

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6
Q

Which types of valves are clots less an issue with and don’t require anticoagulant therapy?

A

tissue valves

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7
Q

Which type of valves require life-long anticoagulation therapy?

A

mechanical

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8
Q

What do mechanical heart valves sound like?

A

ticking clock

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9
Q

What do tissue valves sound like?

A

a lot like normal heart sounds

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10
Q

What is a technical implantation difficulty that could arise?

A

you have a valve that has a small area to sew around

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11
Q

If a patient has a small heart, which valve is a better choice?

A

mechanical

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12
Q

At what age do we start thinking tissue valve?

A

65

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13
Q

If you are less than 65, which valve is normally chosen?

A

mechanical since it doesn’t wear out as soon and people don’t want multiple procedures

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14
Q

Why might a younger person choose tissue valve over mechanical?

A

to avoid anticoagulation

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15
Q

Why might a young women choose tissue valve?

A

anticoagulation therapy with Coumadin can cause fetal death

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16
Q

Why might someone taking care of Down Syndrome patient decide for them to have a tissue valve?

A

less problems on daily basis with no drugs and no frequent labs

17
Q

If someone if already on a blood thinner for something like a. fib, which valve is chosen?

A

mechanical

18
Q

If someone can’t take blood thinner, which valve is chosen?

A

tissue

19
Q

If the position of the valve is in the mitral valve, and since this can already cause a. fib and may have to already be on antocoagulation, which valve may be chosen?

A

mechanical

20
Q

With tissue valves, what happens to the orifice (the outer ring) to annulus (the actual size of the valve) space?

A

gets much smaller proportionally with tissue valves than mechanical valves

21
Q

If a tissue valve fails, is it treatable?

A

yes, very, because the patient will just begin to develop the same symptoms they started with

22
Q

What happens with mechanical valve failure?

A

disc comes out, it clots open or closed

23
Q

how bad is mechanical valve failure?

A

catastrophic

24
Q

How often does mechanical valve failure happen?

A

rarely

25
Q

Do you get the warning symptoms of failure with mechanical valves that you do with tissue?

A

no

26
Q

What is mortality with valve replacement surgery versus CABG?

A

higher

27
Q

Are patients older or younger when they tend to die with valve replacements?

A

older

28
Q

Which type of valve replacement patients have a higher mortality?

A

regurgitant lesions

29
Q

Why do patients with regurgitant lesions have higher mortality?

A

The patient’s hearts have already remodeled to adapt to changes before we see them (this is how they remain symptom-free for so long)

30
Q

What is mortality rate with valve replacement?

A

2%-10%

31
Q

What are valvular surgery complications?

A 
Low CO
HTN
Arrhythmias
Endocarditis
Valve thrombosis
Paravalvular leak
Disc impingement
32
Q

Why do we worry about HTN with valve pts?

A

HTN adds to the problems of big ventricles and strain and could make the ventricles bigger

33
Q

What arrhythmias are caused from valve disease and surgery?

A

a.fib - may already have or from handling heart
PVCs from large ventricle
heart block from calcium

34
Q

Why is endocarditis a worry for valve replacement?

A

there is a foreign body in the patient’s heart

35
Q

Why is embolization a problem with mechanical valves?

A

blood can get caught in valve hinges and form clots

36
Q

What happens when most of the blood flows through the valve , but some is coming back or around the sewing ring?

A

paravalvular leak

37
Q

What happens when a part or piece of the heart or sewing thread is causing interruption of the disc functioning?

A

disc impingement

38
Q

What are long-term complications with valve replacement?

A

complications of anticoagulation
thrombi
endocarditis

39
Q

What is important to give patients on anticoagulation therapy?

A

EDUCATION

From Flashcardlet (107 decks)

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