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Echo > Interventional/Advance/Transplant > Flashcards

Interventional/Advance/Transplant Flashcards

1
Q

Myocardial Strain Imaging

What is strain?

A

Strain is a measure of how much an object has been deformed represented by a percent or fractional change in dimension.

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2
Q

lengthening and thickening of myocardial fibers

A

Positive strain

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3
Q

shortening and thinning of myocardial fibers

A

Negative strain

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4
Q

Myocardial Strain Imaging

Clinical application

A
    • Used as a marker of myocardial function*
    • Detect changes in regional function*
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5
Q

Left Heart Cath

performed with ______

A

pigtail catheter

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6
Q

LV cath procedures (3)

A

coronary angiogram - assesses the coronary artery for CAD (gold standard)

Angioplasty (aka: percutaneous transluminal coronary angioplasty/PTCA)

IVUS - intavascular ultrasonography

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7
Q

IVUS stand for

A

intravascular ultrasonography/ultrasound

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8
Q

Right Heart Cath

performed with

A

Swan-Ganz catheter

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9
Q

right heart cath procedures

A

transseptal procedure

fluoroscopy

acquire LAP via pulmonary capillary wedge pressure

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10
Q

IVUS contraindications:

A

severe HTN

ventricular arrhythmia

acute MI

allergy to radioactive contrast

GI bleeding

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11
Q

__________ provides a bloodless field for cardiac surgery. It incorporates an extracorporeal circuit to provide physiological support in which venous blood is drained to a reservoir, oxygenated and sent back to the body using a pump.

A

Cardiopulmonary bypass (CPB)

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12
Q

_________________________ is a mature imaging modality and critical component of contemporary heart surgery, in which it plays a key role in surgical planning, determination of cardiac chamber filling and function early after cardiopulmonary bypass, and timely assessment of surgical interventions.

A

Intraoperative TEE

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13
Q

This technique uses a small catheter with a miniature ultrasound transducer to visualize the internal vascular anatomy

A

IVUS

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14
Q

2 types of IVUS

mechanical and phased array

pros and cons?

A
  • Mechanical (Uses a single mechanical transducer that is mounted at the catheter tip and rotates at 1800 rotations per minute (rpm)
    • Image display: cross-sectional view of artery
    • Pros: High image quality
    • Cons: decreased catheter flexibility
  • Phased array
    • Use multiple TDR elements
    • Pros: more flexible
    • Cons: lower temporal resolution
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15
Q

***IVUS mechanical TDR catheter tip rotates at ______ per min and measure entire vessel diameter

A

1800

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16
Q

What is ICE?

A

intracardiac echocardiography i.e. AcuNav

*Note:

要は… guiding/monitoring for:

IAS closure, LAA closure, PV ablation, transluminal septal myocardial ablation

Peri-interventional imaging of:

Asc Ao, AoV, Dsc thoracic Ao, MV

Point:

High frequency rotating catheter probes in the range of 20-30 MHz

Intracoronary investigations: atherosclerosis, vascular response to stents and coronary remodeling

Guidance for placement of closure devices for ASDs, electrophysiological ablation procedures, alternative guiding tool for intervention procedures especially in pediatric patients.

Does not require general anesthesia

17
Q

***Cardiac Transplant: Echo Features of Rejection (4)

A
  1. increase in LV wall thickness >4mm
  2. >10% decrease in LV/RV systolic function
  3. increase in RVSP
  4. new or sudden change in PE
  5. restrictive filling: > 20% decrease in pressure half time from immediate post operative echo, E/e’ > 8, 20 % decrease in IVRT
18
Q

Cardiac Transplantation Complications: (4)

A

CAD (graft atherosclerosis)

infection

rejection

silent MI due to denervation (chest pain receptors are cut, resulting in inability to feel angina and altered conduction pathways)

)

19
Q

cardiac transplantation

primary indication (3)

A

dilated CM

cardiac amyloid disease

CHD

20
Q

Surgical Techniques used in Cardiac Transplantation

the recipient’s heart is removed and the donor’s heart is placed in the correct anatomical position

A

Orthotopic (biatrial or bicaval)

21
Q

Surgical Techniques used in Cardiac Transplantation

the donor heart is placed in the right chest alongside the recipient organ and anastomosed in a way to allow blood to pass through either or both hearts.

A

heterotopic

22
Q

Surgical Techniques used in Cardiac Transplantation

transplantation of the heart from a different species

A

xenotransplantation

23
Q

Surgical Techniques used in Cardiac Transplantation

  • surgically implanted mechanical heart designed to replace the diseased heart
A

artificial heart

24
Q

a type of therapy used for patients in end stage LV dysfunction

A

CRT

25
Q

what does CRT stands for?

A

cardiac resynchronization therapy

26
Q

__________ is the result of premature regional contraction before ejection or delayed regional contraction. It disrupts the normal coordinated sequence of contraction and results in a decrease in EF

A

Dyssynchrony

27
Q

3 types of dyssynchrony:

A

Interventricular dyssynchrony

  • Result from LBBB due to abnormal septal motion
  • Measured by Doppler (difference between the left and the right ventricular pre-ejection intervals from onset of QRS to onset of aortic and pulmonary outflow
  • Difference in ejection delays > 40 ms is a sign of interventricular dyssynchro

Intraventricular dyssynchrony

  • May cause reduced SV & abnormal myocardial stress
  • Assess by M-mode from PSAX
  • Septal to posterior wall motion delay is marker

Atrioventricular (AV) dyssynchrony

May also lead to heart failure; however, there is limited information on the effects of AV resynchronization.

28
Q

what is LVAD ?

A

(left Ventricular Assist Device)

  1. Screen for AR or LV apical thrombus prior to implantation
  2. Use Doppler to evaluate pump setting
29
Q

LV pseudoaneurysm is a rare but serious complication of MI, cardiac surgery, trauma and infection.

____% mortality rate (medical treatment frequently ineffective)

Surgery = high mortality therefore _________ is highly effective

A

50

transcatheter closure

30
Q

Mitraclip System is based on the principle of _________

technique is a method to treat mitral valve regurgitation by suturing the edges of the leaflets at the site of regurgitation. Although the method is technically simple, its application should follow a few rules to ensure effective and durable results, and to avoid complications.

A

edge-to-edge repair

31
Q

TAVR stands for

A

transcatheter aortic valve replacement

32
Q

Type of TAVR: balloon expandable

A

Edward SAPIEN & SAIEN -XT

33
Q

Type of TAVR: self expanding

A

Medtronic Core Value

34
Q

_______ is so important because it represents the average of the longitudinal strain of all myocardial segments obtained in A4C, A2C & A3C.

A

GLS

35
Q

Of all the parameters,

__________ is the most used one because it represents the shortening of the subendocardial fibers

which are the first fibers to be affected in most cardiopathies.

A

Longitudinal strain

36
Q

lengthening and thickening of myocardial fibers = ______strain

A

Positive

37
Q

shortening and thinning of myocardial fibers = _______ strain

A

Negative

38
Q

__________ is a procedure done to remove fluid that has built up in the pericardium. It’s done using a needle and small catheter to drain excess fluid.

A

Pericardiocentesis

39
Q

________________is performed by placing the ultrasound transducer on the epicardial surface of the heart to acquire 2-dimensional and color flow, and spectral Doppler images in multiple planes.

A

Epicardial echocardiography

Echo (35 decks)

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