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echo > Interventional / Intraop > Flashcards

Interventional / Intraop Flashcards

1
Q

TAVR low implantation complications

A

Paravalvular regurgitation
MV disruption
CHB

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2
Q

Underexpanded TAVR complications

A

Paravalvular regurg
Prosthetic regurg
Decreased durability

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3
Q

Seimquantitative Parameters for TAVR paravalvular regurgitation

A

Jet width at its origin (% LVOT diameter)
PHT
Descending aortic diastolic flow reversal
Circumferential extent of paravalvular regurgitation

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4
Q

TAVR paravalvular Jet width at origin

A

Mild 5-15%
Moderate 30-45%
Severe >60%

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5
Q

TAVR paravalvular PHT

A

Mild > 500
Mod 200-500
Severe < 200

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6
Q

TAVR paravalvular descending aorta diastolic flow reversal

A

Mild - absent or brief
Moderate - intermediate
Severe - holodiastolic

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7
Q

TAVR

Circumferential extent of paravalvular regurgitation

A

Mild <10%
Mod 10-29%
Severe >= 30%

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8
Q

TAVR paravalvular

RVol

A

Mild < 15
Mod 30-45
Severe > 60

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9
Q

TAVR paravalvular RF

A

Mild < 15%
Mod 30-40%
Severe > 50%

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10
Q

TAVR paravalvular ERO

A

Mild < 0.05
Mod 0.10-0.20
Severe > 0.30

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11
Q

Ideal TMVR segment

A

P2

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12
Q

Ideal TMVR calcification

A

None

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13
Q

Ideal TMVR MVA

A

> 4 cm2

may attempt 3.5-4cm2

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14
Q

Ideal TMVR MV gradient

A

<4 mm Hg

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15
Q

Ideal TMVR flail width

A

<15 mm

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16
Q

Ideal TMVR flail gap

A

<10 mm

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17
Q

Flail width

A

Width along scallop

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18
Q

Flail gap

A

Distance between anterior and posterior leaflets

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19
Q

Suboptimal TMVR anatomy

A

Prior endocarditis
Rupture / perforation
Bulky MAC
Small baseline MVA

20
Q

TMVR complications

A 
Device embolization rare
Partial clip detachment 2%
MS 0.5%
Tamponade 2%
Injury to atrial septum repair
21
Q

Percutaneous paravalvular regurgitation repair complications

A 
Prosthetic leaflet impingement (tilting disc)
Device embolization
Coronary obstruction (aortic)
Stroke / TIA
Pericardial effusion
22
Q

TEE sizing for LAAO

A

Measure at every 45 degrees
Measure osmium and depth in each view
Use largest diameter, usually at 135 degrees

23
Q

LAAO complications

A

Effusion / tamponade 1.3%
Device embolization 1.3%
Stroke 0.7%

24
Q

MV repair leading to LV and RV dysfunction

A

Pre-op LV dysfunction unmasked
Air down coronaries
Lcx artery issues
New MI

25
Q

TV repair rec when undergoing MV surgery

A

Annulus >= 3.5-4.0 cm

26
Q

MV scallops 4 chamber view

A

anterior and posterior leaflet

27
Q

MV scallops commissural view 60’

A

3 medial - 2 middle - 1 lateral

28
Q

3D echo surgeon’s view MV scallops

A

A1 / P1 lateral
A2 / P2 middle
A3 / P3 medial

29
Q

MR jet not going in expect direction based on anatomy

A

Cleft like indentation

30
Q

Intraop air embolization coronary territory

A

RCA

31
Q

TEE for LVAD placement indication

A

Exclusion of AR

32
Q

Most specific criteria for severe MR

A

ROA >= 0.4 mm2

VC >= 7 mm

33
Q

Underfilled LV and LV volumes / EF

A

Decreased EDV, ESV

Increased EF

34
Q

Most common transient abnormality after placement of stented bioprosthesis

A

Small periprosthetic regurgitation

35
Q

Complication of MV repair when LV small and hyperdynamic

A

SAM

36
Q

EF on CPB

A

May be higher or lower

37
Q

Preferred TEE view for LV apex

A

Transgastric long axis of LV

38
Q

TEE aorta blind spot

A

Mid ascending aorta

Caused by trachea between aorta and esophagus

39
Q

MR caused by AR

A

Perforation of leaflet by AR jet

40
Q

Intervalvular fibrosa

A

Posterior part of AV annulus
Anterior part of MV annulus
Septal side of TV annulus
Solid structure to which AV attached anteriorly, MV attached posteriorly

41
Q

Risk for coronary obstruction with TAVR

A

Height of left main <10 mm above annulus

Female sex

42
Q

Ideal TMVR coaptation length

A

> = 2 mm

43
Q

Ideal TMVR coaptation depth

A

<= 11mm

44
Q

Complications of LARIAT device

A

Access complications
Pericarditis, pericardial effusion
Unexplained sudden death
Late stroke

45
Q

Successful alcohol septal ablation

A

reduction of LVOT gradient >=50%

46
Q

Can’t use LARIAT with this type of LAA

A

Chicken wing

echo (30 decks)

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