Cardiac/Thoracic

Question 1

INRs for mechanical valves

Answer 1

Aortic→ INR 2.5-3.0
Mitral→ INCR 3
Tricuspid→ INR 3

Question 2

Aortic aneurysms:
Ascending vs descending vs abdominal

When to repair

Answer 2

Ascending: grows >10 mm/year, > 6 cm (5 marfans)
Descending: 6-7 cm
Abdominal:
unstable emergent repair
Stable: 5.0 cm, increased size by >0.5cm q 6 months

Question 3

Aortic aneurysms:
Ascending vs descending vs abdominal

Imaging

Answer 3

Ascending: 6 months after, annual if no growth, q3-6 months if growth

Descending:
4-5 cm: annual
5-6 cm: biannual

Abdominal:
3-4 cm: annual
>4 cm: q6 months

Question 4

Type A vs Type B Aortic dissection

Answer 4

A: emergency surgery
B: when 5-6 cm or rapid expansion, endovascular stent grafting

Question 5

thoracic means

Answer 5

all surgery EXCEPT the heart

Question 6

Type A vs Type B Aortic dissection: follow up

Answer 6

A: ???
B: 2, 6, 12 months then annually

Question 7

TAA=

Answer 7

Descending Thoracic Aortic Aneurysm

Question 8

With aneurysms, SBP goal is

Answer 8

105-120 mmg Hg

Question 9

Ectasia

Answer 9

Abdominal aorta of 1.5 cm to 2.9 cm

Question 10

ABIs

Answer 10

• ABI 1.0-.9→ Normal
• ABI 0.8 → asymptomatic
• ABI 0.6-0.5 → claudication
• ABI 0.2-0.4 → rest pain, ulcers will not heal