Heart Valve Replacement Flashcards
How many leaflets does the Aortic Valve have?
Three leaflets
What are some causes for an Aortic Valve Replacement?
- Stenosis (stiff valves)
- Regurgitation (back flow)
What are some causes of Regurgitation?
- Prolapsed leaflets
- Endocarditis
- Congenital malformation
- Aortic arch aneurysm
What are the steps for an Aortic Valve Replacement?
- Median sternotomy performed
- Cardiopulmonary Bypass is placed
- Damaged valve is removed
- Sutures with pledgets placed around annulus of valve
- Ends of suture passed through new valve
- New valve lowered into placed and sutures are tied
What is the purpose of using sutures with pledgets on the Aortic Valve?
The pledgets plug the “holes” made by the needle as you pass suture through the annulus
True or False: You must alternate the colors of sutures with pledgets around the annulus of the Aortic Valve.
True
-Alternate colors to keep organized for hand tying
What type of suture can be used to suture in the new Aortic Valve?
2-0 Ethibond
2-0 Mersilene
-Horizontal mattress stitch
When is a Mechanical Valve used in an Aortic Valve Replacement?
- Patient younger than 65
- Higher risk for thrombosis
When is a Biologic Valve used in an Aortic Valve Replacement?
Patient older than 65
What is the benefit of a Mechanical Valve?
Longevity (Last 20-30 years)
What is a drawback of a Mechanical Valve?
Patient must begin lifelong anticoagulant therapy
What is a drawback of a Biologic Valve?
- Structural deterioration begins after 5 years
- Reoperation needed after 10-15 years
- Patient may have issue with Porcine/Bovine graft
What suture is used to close the arteriotomy?
4-0 Prolene
What are the steps after the valve is replaced during an Aortic Valve Replacement?
- Suture then unclamp Aorta
- Allow backflow to remove air from the Heart
- Remove patient from Bypass machine
- 32F chest tube drain and pacemaker wires placed
- Sternum and incision are closed
