Ch 7 TV + PV Regurg Flashcards
Cause of TR?
Primary (structural) valve disease or secondary (functional) valve dysfunction
Is primary or secondary TR m/c?
Secondary
M/c cause of primary TR?
Myxomatous degeneration
Is rheumatic TR or TS m/c?
TR
SF of carcinoid heart disease?
Thickened, shortened + immobile leaflets
Endocarditis causes TR + is m/c in pt’s with a history of ___?
Intravenous drug use
What is ebstein’s anomaly?
-Congenital anomaly where 1 or more of the TV leaflets are displaced from the annulus, located towards the apex
-MV + TV are separated greater than 1 cm
Which leaflet is m/c apically displaced with ebstein’s anomaly?
Septal leaflet (in isolation or with the post + ant leaflets)
What are some changes to the RV + RA due to TR?
-RV + RA enlargement
-Septal flattening (throughout cardiac cycle)
-RV volume overload is associated with a pattern of abnormal septal motion (seen in m-mode by posterior motion of septum in diastole + anterior motion in systole)
-Aka paradoxical septal motion
Quantification methods?
-Jet area
-Vena contracta
-PISA (not commonly used clinically for TR)
How to calculate jet area?
Large central jet filling > 50% of the RA indicates severe TR
or
CD jet area of > 10 cm^2
RVSP determines what?
Presence of pulmonary hypertension within a pt
RVSP formula?
4(V)^2 + RAP
How to obtain RVSP?
1: IVC size (measure 1-2cm from junction with RA, should be < 2.1cm)
Surgery of which valve has one of the highest morbidity + mortality rates of all cardiac surgical procedures?
TV
M/c cause of significant PR?
Previous surgery from tetralogy of fallot
List 3 CD quantification methods for PR?
CD jet area:
Narrow jet = mild
Wide jet that fills RVOT = severe
Jet length:
<10 mm is insignificant
Vena Contracta:
> 0.5 ms is severe
Holodiastolic flow reversal in the PA is a sign of ___ PR?
Severe PR
How does mild vs severe PR appear on doppler?
Mild: soft/faint signal with slow deceleration
Severe: dense/bright jet with rapid deceleration
PHT of < ___ msec is consistent with severe PR?
<260
When is PV replacement indicated?
In pt’s with severe PR + NYHA class 2 or 3 symptoms
How is PV replacement typically performed?
With a homograft or xenograft
