Cardiac Surgery: Valve Repairs & Replacements

Question 1

Causes of Valvular Disease?

Answer 1

Congenital malformation, bacterial endocarditis, rheumatic fever, valve prolapse, myocardial infarction

Question 2

Valves are usually replaced with _______ or ______ prostheses

Answer 2

Biological or mechanical prostheses

Question 3

What kind of valves require shorter term anticoagulation?

Answer 3

Biological valves

Question 4

What kind of valves require lifelong anticoagulation?

Answer 4

Mechanical valves

Question 5

Mechanical valves are usually manufactured from

Answer 5

Titanium alloys

Question 6

Valvular surgery will either be a

Answer 6

Repair (valvuloplasty/annuloplasty) or a Replacement (bioprosthesis or a mechanical prosthesis)

Question 7

Whats the evidence like for prophylactic respiratory therapy after cardiac surgery?

Answer 7

Evidence is lacking

Question 8

What is some medical management of Valvular Disease?

Answer 8

• Controlling arrhythmias (drugs)
• Prevention of emboli (anticoagulants)
• Prophylaxis against infective endocarditis
• Treating associated heart failure (i.e. vasodilators, diuretics to control oedema, drugs to increase contractility)

Question 9

What kind of valves last longer?

Answer 9

Mechanical, biological valves usually up to 10 years (some say 17 years)

Question 10

Biological valves require shorter term anticoagulation, approximately how long?

Answer 10

3 months

Question 11

What kind of valves have a higher risk of valve infection?

Answer 11

Mechanical (endocarditis)

Question 12

Mitral Regurgitation is a disorder in which

Answer 12

The heart valve that separates the upper and lower chambers on the left side of the heart does not close properly. Can result from endocarditis, rupture of chord tendinae muscle / papillary muscle dysfunction (i.e. after a MI).
Signs of pulmonary congestion can occur (i.e. pulmonary oedema)

Question 13

Aortic Stenosis is a disease

Answer 13

of the heart valves in which the opening of the aortic valve is narrowed. This can obstruct blood flow from your hear to the rest of your body. The aortic valve is between the left ventricle and the aorta. Signs and symptoms include being asymptomatic, angina on exercise, sudden death, fatigue and dizziness.

Question 14

Pulmonary Oedema is a condition in which

Answer 14

Fluid accumulates in the lungs. It can lead to impaired gas exchange and cause respiratory failure