Valvular Disease Flashcards
(67 cards)
Symptomatic MS- intervene if MVA is —-
1.5 or less
If MVA is less than 1 and pt asymptomatic what to do
If valve suitable for BMV-do it . IIb:Otherwise monitor
Severe MS is
MVA 1.5 or less- ACC/AHA-2014
Moderate MS is 1.6-2 cm2
Very Severe MS is 1 cm2 or less
Stage B or Progressive MS is MVA of
More than 1.5 and pressure half time < 150
ACC/AHA classification of VALVE diseases
Stage A-at risk;
B- progressive
C-Asymptomatic
D-Symptomatic
PASP for decisions on MS
50 mm Hg
MV replacement indications in MR i.e. The definite indications
- symptoms+EF>30
- Asymptomatic and LVESD at least 40
If in symptomatic pts EF 30 or less a weak recommendation is that Mitral Valve repair can be considered
Role of Afib and PASP in deciding MV surgery
Asymptomatic Severe MR with Afib or PASP >50 can consider REPAIR if success high
Mitral valve repair best with–//
Chordal rupture repair best with
Posterior leaflet
Posterior chordal rupture
Mitral valve cusp at intervalvular fibrosa
A3 cusp
Pml forms — part of annulus
5/8
But Total area of Aml and pml are same in systole
The name of commissures come from the papillary muscles - anterolateral and posteromedial
Most commonly fused cusps in Bicuspid Aortic valve
Right and left
Difference between rheumatic and degenerative AS in Echo is
Degen-near Aortic ring. Rheumatic less involvement near the ring
Effect of ARB or Betablocker in ascending aortopathy of Bicuspid Aortic valve
No studies demonstrated benefit.2014 ACC/AHA did not recommend any pharmacologic treatment in the absence of another indication like HTN
When to do Surgery for Aorta in Bicuspid Aortic valve
- > 5.5 cm at root or Asc Aorta
2. If growth rate >.5cm/year or if surgical risk <4%ie expert centre or families history of dissection consider at 5 cm
VCW in Severe MR
0.7 cm or more
0.3cm VCW is mild or mod MR
Moderate MR
E velocity in Severe MR
More than 1.4 cm/s
E/A ratio in Severe MR
2 or more
V wave cut off sign indicates
Severe MR in CWD
Surface velocity of PISA is
Equal to the chosen Aliasing velocity
Effectiveness of PISA in quantifying MR
Moderate accuracy
EROA by PISA eqn
2#r 2 x aliasing vel. / peak MV vel
Normal pulmonary venous flow during Doppler
Antegrade in both systole and diastole with systole dominant
With slight retrograde flow during atrial syst
In Severe MR-Systolic flow reversal
