High Yield PTEexam Review part 27-29 Flashcards
What does the mitral valve inflow velocities show with a-fib?
No a-wave
What is the property of Medtronic Hall valve?
Large central jet through central aperture
What is a property of the Saint Jude Bileaflet Mechanical valves?
Convergent washing jets
What is the property of On-X bileaflet mechanical valve?
Divergent Washing jets
What is the property of Starr Edwards valve?
No washing jets
High gradients
Very durable
High thrombotic risk (Fallen out of favor)
What is the property of Bjork-Shiley valve?
Single tilt disc valve
Embolized
Taken off market
What is the property of Medtronic Freestyle valve?
Entire porcine root
What is the property of Pericardial valve (Carpentier-Edwards) valve?
Small Struts
Central Gap
Thick Leaflets
Where would perimembranous and Subpulmonic VSD be found?
Least common location for myxoma?
Aortic Valve
Are myxoma more common in men or women?
Women
What age group are myxoma most common?
30-60 years old
What % of cardiac tumors are:
Benign vs. Malignant?
Benign = 75%
Malignant = 25%
After myxoma, what are the most common benign cardiac tumors?
Lipomas (8%)
Papillary Fibroelastoma (7.9%)
Rhabdomyomas (6.8%)
What is the most and least common malignant cardiac tumors? (Broad categories)
95% sarcoma
5% lymphoma
If the valves are not a possible answer for least common location for myoxma, what is the least common location (Excluding valves)?
LV/RV = 2%
What is a way you can tell a sinus of valsalva rupture vs. VSD?
- SoV rupture = Higher diastolic flow than VSD
- Jet location
You are given peak velocity of 3.58 m/s with subpulmonic VSD. BP is 100/60. What is the RVSP?
LVSP - RVSP = 4 (V)2
VSD flow dominates during systole or diastole?
Systole
What is a Gerbode defect?
LV to RA defect (communication)
When does a gerbode defect occur?
Aortic valve abscess
AV repair with close communication
What is the expected gradient of Gerbode?
120/12 - 8 = 112 mmHg
What is the expected gradient of TR jet?
25 - 8 (See pressures in systole)
= ~17 mmHg
What are the expected gradient of VSD?
120 - 25 (95 mmHg)
What are the expected gradient of ASD?
10 - 8 = 2 mmHg
What are the expected gradient of MR?
120 - 10 mmHg = 110 mmHg
What are the expected gradient of A.I.?
80 - 12 = 68 mmHg
What are the expected gradient of PDA?
120 - 25 = 95 mmHg
When would flow dominate with TR jet?
Systole
When would flow dominate with MRR?
Systole
When would flow dominate with VSD?
Systole
When would flow dominate with ASD?
Diastole (Depending on compliance difference)
When would flow dominate with PDA?
Both systole and diastole but dominates during systole
What is this?
Sinus of Valsalva Aneurysm
What is the difference in genetic penetrance vs. expressivity?
What cardiac disease is this seen?
Penetrance is used to describe whether or not there is a clinical expression of the genotype in the individual.
Expressivity is the term that describes the differences observed in the clinical phenotype between two individuals with the same genotype.
Disease = HOCM
Why do you have a late peaking “Dagger” shape to CWD profile in HOCM?
Early = No obstruction because LV is full
Late = More obstruction and more empty therefore the obstruction occurs later in the CWD profile
What is at the arrows?
Septal Perforators after septal myectomy
How do you tell a septal perforator from VSD after septal myectomy?
Septal Perforator flow = Diastolic blood flow (Seen in picture)
VSD flow* = *Systolic blood flow
What wall is always spared in HOCM?
Basal inferolateral wall
What is the correct distance of an impella device placement through the AV into the LV?
3.5 to 4 cm
What type of artifact is seen here? (2 names)
What is this due to?
Ring down artifact
AKA Comet Tail
Due to Reverberation
This was found after bypass and then went away after surgical manipulation. What is the diagnosis?
If it went away its an inverted LAA
