AV Valve Abnormalities Flashcards
Ebstein’s anomaly is the apical displacement of the ____ and ____ TV leaflets toward the RV chamber, leading to “atrialization” of the RV.
Septal and posterior
With ebstein’s, the ____ leaflet inserts in normal/near-normal position.
Anterior
With Ebstein’s, heart size and severity of symptoms are directly related to the degree of ____ displacement of the tricuspid valve.
Downward
Moderate to severe Ebstein’s can cause ____.
Cyanosis
____ view is best for visualizing extent of apical displacement of septal TV leaflet.
Apical 4 chamber
When the TV is displaced, you should measure the separation of TV to MV ____.
Insertion
The criteria for Ebstein’s diagnosis: apical displacement index must measure greater than ____ mm or ____ mm/m^2
20 mm; 8 mm/m^2
What are the most common structural causes of MR?
Cleft mitral valve and MVP
As MR worsens, LA pressure increases. This increased pressure will be transmitted back through the ____ into the pulmonary vascular bed.
Pulmonary veins
Cleft mitral valve usually involves the ____ MV leaflet.
Anterior
Congenital MS is rare and usually the result of a ____, ____, or ____.
Double orifice MV, fused commissures, or parachute MV
Double orifice MV is a result of ____ tissue which divides the mitral orifice into two smaller openings.
Anomalous
A ____ MV consists of: two leaflets + chordae tendinae + one papillary muscle.
Parachute
____ is when there is a membrane that partitions the LA into 2 parts, one which receives the pulmonary veins, and one (true atrium) which usually contains the LA appendage and the fossa ovalis
Cor triatriatum
Cor triatriatum is caused by incomplete absorption of the common ____ leaving an obstructing membrane of tissue.
Pulmonary vein
Cor triatriatum’s secondary signs are similar to ____; RVH, PHTN, LAE.
MS
____ is when there is extra connective tissue in the LA, just above the MV, which encroaches on the MV leaflets and may obstruct mitral inflow.
Supravalvular mitral ring
A single ventricle can also be referred to as a ____ or a ____.
Common ventricle or Univentricular heart
A single ventricle causes blood flow from the ____ and ____ to dump into one main ventricle.
TV and MV
Since the blood in a single ventricle is mixed, ____ in the PA and aorta may be identical.
Oxygen saturations
With a single chamber ventricle, the prominent chamber is ____ ventricular in character (80%).
Left
With a single ventricle, the volume of blood flow to each great vessel is determined by the ____ in each arterial vessel.
Resistance
Unless pulmonary resistance is greater than systemic resistance, there will be an increase in the volume of flow to the ____ compared to the ____ flow.
Pulmonary artery; aortic
____ is the absence of TV resulting in no communication between the RA and RV.
RV is hypoplastic.
Tricuspid atresia
With tricuspid atresia an ____ has to be present, allowing blood to leave the RA and travel via the LA to the LV.
ASD
With tricuspid atresia, the RV is ____, but still has to be functional enough to contract and pump blood into the PA.
Hypoplastic
____ is the congenital absence of the mitral valve.
Mitral atresia
The blood flow for mitral atresia is as follows:
LA > ASD > RA > RV > VSD > aorta.
A double inlet ventricle is when one large ventricle which receives inflow from both ____ valves.
AV
What are the four types of double inlet ventricle?
- Double inlet LV - dominant large LV with small rudimentary RV (most common)
- Double inlet right ventricle
- Double inlet ventricle of mixed morphology (absence of IVS)
- Double inlet ventricle of indeterminate morphology
The final operation for double inlet ventricle is often the ____ operation.
Fontan
The Fontan operaton is when the IVC blood has been routed to the ____, in this example using the extra-cardiac conduit technique.
PA
