Aorta

Question 1

The aortic dissection mortality rate

Answer 1

1-2% per hour for the first 48 hours

Question 2

Stanford classification

Answer 2

Type A - Ascending aorta; Type B - distal to left subclavian

Question 3

Debakey classification: type 1

Answer 3

Originates in the ascending aorta and involves both ascending and desc aorta

Question 4

Debakey classification: type 2

Answer 4

limited to the ascending aorta and all involvement is proximal to the innominate artery

Question 5

Debakey classification: type 3a

Answer 5

originate in the descending thoracic aorta distal to the takeoff of the left subclavian artery. Type 3a is confined to the thoracic aorta. Type 3b dissection extends distally below the diaphragm.

Question 6

Intramural hematoma

Answer 6

a precursor to aortic dissection; treat similar to a dissection

Question 7

Indication for aortic root replacement in asymptomatic patients

Answer 7

5.5 cm

Question 8

Indication for aortic root replacement in patients with connective tissue disorder or bicuspid valve

Answer 8

4.5-5 cm. Of note, current studies suggest that the risk of progressive aortic arch dilatiion is limited in BAV, and that routine arch replacement is not necessary. Similarly, a finding of normal size aortic sinuses appears to be benign in BAV patients, as the natural histories of sinus and ascending aortic dilation are not always linked.

Question 9

Indication for aortic root replacement if the patient is planned for an ascending aortic repair/replacement

Answer 9

> 4.5cm

Question 10

Blunt aortic injury ofter occurs at?

Answer 10

the aortic isthmus, at the level of the ligamentun arteriosum. Immediate repari is warranted

Question 11

Immediate repair is needed in blunt aortic injuries. What are the treatment options:

Answer 11

1. Endovascular stent graft (preferred)
2. Open repair via L thoracotomy
   Delayed repair may be warranted if significant injury elsewhere

Question 12

Incidence of heart block after AVR

Answer 12

5-10%

Question 13

Which interleaflet triangle is the conduction bundle found?

Answer 13

Between the right and non-coronary leaflets

Question 14

Risk factors for pacer requirements after AVR (6)

Answer 14

1. Preop first degree block
2. intraventricular conduction abnormality
3. Severe MR
4. combined cabg or mitral operation
5. Subaortic stenosis
6. Re-do operations