Valve Replacement and Congenital Disease Flashcards
(21 cards)
what are the advantages and disadvantages of a mechanical valve?
advantage is that they last forever
disadvantage is that the patient requires anticoagulation for the remainder of their lives
what are the advantages and disadvantages of bioprosthetic valves?
advantage is that anticoagulation is not needed
disadvantage is that they wear out after 12-15 years
what is the EBL for a mitral valve replacement?
300-400 mL
how do patients with mitral regurgitation and mitral stenosis react postoperatively?
MR patients usually do well, and require minimal inotropes
MS patients may require significant inotropes
which patients generally have a better prognosis, those with aortic regurgitation or those with aortic stenosis?
aortic stenosis
what are the three types of shunts?
simple
bidirectional
complex
what five lesions are characterized by excessive pulmonary blood flow?
atrial septal defect ventricular septal defect atrioventricular septal defect truncus arteriosus hypoplastic left heart
what four lesions are characterized by inadequate pulmonary blood flow?
transposition of great vessels
TOF
tricuspid atresia
total anomalous pulmonary venous return
in patients with coarctation of the aorta, where are they hypertensive and where are they hypotensive?
they are hypertensive in the upper body, and hypotensive in the lower body
what should be done with the ductus arteriosus in patients with coarctation of the aorta?
keep it open with PGE1
what are three ways to lower CHF in a neonate?
PGE1 to open PDA
PPV
diuretics
where should the BP cuff be placed in a patient with coarctation of the aorta?
lower extremity
what should be expected in an ABG after cross-clamp release?
acidosis
what is post-coarctectomy syndrome?
abdominal pain
abdominal distension
N/V
hypertension
what is Marfan syndrome?
a disorder of connective tissue, a defect of collagen synthesis that decreases connective tissue strength and elasticity
Marfan syndrome is a mutation in what gene?
FBNI
what are three physical symptoms of Marfan syndrome?
pectus excavatum
arachnodactyly
dilation of the aorta
what is a big intraoperative risk for patients with Marfan syndrome?
aortic arch dissection
they also have mitral or aortic valve regurg
what two preoperative medications should be given to patients with Marfan syndrome?
SBE prophylaxis
beta blockers, to prevent increased inotopy and aortic wall tension
why should you be careful positioning patients with Marfan syndrome?
high risk of dislocation
what are two airway abnormalities in patients with Marfan syndrome?
high arched palate
cervical instability
