Aortic Stenosis

Question 1

Stage B AS in an indication for AVR if other surgery is indicated

Answer 1

Yes

Question 2

The most reliable finding to exclude severe AS in adults.

Answer 2

The presence of a normally split S2

Question 3

Gallavardin phenomenon

Answer 3

Radiation of AS murmur to apex specially in elderly patients

Question 4

What is the indexed EOA

Answer 4

It is the EOA \ BSA

If it is <= 0.65 that means there is severe patient prosthesis mismatch which is further supported by a an acceleration time of <= 100 versus >100 in patients with pathologic obstruction of prosthesis

Question 5

Prosthesis thrombosis

Answer 5

elevated transvalvular velocity and gradient; a prolonged (>100 msec) acceleration time; a reduced effective orifice area (<1 cm2); and a reduced dimensionless index (<0.3).

Question 6

What are the additional risk factors for thrombosis in mechanical AV were target inr go up to 3 and bridging for surgery is indicated

Answer 6

atrial fibrillation, previous thromboembolism, hypercoagulable condition, older-generation mechanical valves [ball-cage or tilting disc], left ventricular systolic dysfunction, or >1 mechanical valve).

Question 7

In patients with bicuspid aortic valve who have an indication for AVR, the ascending aorta should be replaced if

Answer 7

If its >4.5 cm