Mitral Valves Flashcards

0
Q

Which MV leaflet has larger surface area but occupies only 1/3 of annulus?

A

Anterior

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1
Q

Whi regards to MV segments, which one is medial and which is lateral?

A
Medial= 3 
Lateral = 1
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2
Q

Which MV leaflet has smaller surface area but occupies 2/3 of the annulus?

A

Posterior leaflet

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3
Q

What to look for opinion cath tracings for MS?

A

At diastole, LAP»LVP

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4
Q

What valve area, mean gradient, and systolic PAP defines moderate MS?

A

MVA: 1-1.5cm
Mean grad : 5-10
PAP: 30-50

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5
Q

What stage of MS is asymptomatic, MVA150ms, severe LAE?

A

C

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6
Q

What stage of MS is symptomatic, MVA150ms, severe LAE?

A

D

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7
Q

What does it mean when opening snap in MS is early?

A

MS is severe

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8
Q

If a pt with MS develops Pulm HTN, what is their median survival in years?

A

<3 y

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9
Q

Besides MV replacement, what is a surgery for MS?

A

Mitral commissurotomy

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10
Q

Wilkins score for MS gives 4 points to each of the following:

A
  • leaflet thickening
  • leaflet calcification
  • leaflet mobility
  • subvalvular thickening
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11
Q

What MVA is considered severe MS?

A

<1.5cm

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12
Q

According to 2014 guidelines, if a pt has Progressive MS (MVA>1.5cm, PHT<150ms) but has sxs with no other cause, what is best next step?

A

See if PCWP >25 with exercise, and if so, you can do PMBC (IIb)

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13
Q

What ERO and Regurgitant Volume define severe MR?

A

ERO> 40

RVol> 60

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14
Q

With normal LA and LV, can MR be severe?

A

No

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15
Q

Causes of MR

A
Rupture (Pap m, chordal, leaflet)
Endocarditis
MVP
ischemia
Rheumatic
16
Q

In acute MR, how loud will murmur be?

A

Soft

17
Q

What stage if MR is asymptomatic, severe (jet area >40% LA, RVol>60cc, ERO>.4, LAE, PHTN) and EF>60%/LVESD<40mm?

A

C1

18
Q

What stage if MR is asymptomatic, severe (jet area >40% LA, RVol>60cc, ERO>.4, LAE, PHTN) and EF40mm?

A

C2

19
Q

What stage of MR is severe, sxs (dec ET)?

A

D

20
Q

Type I MR mech

A

Annular dilatation

21
Q

Type II MR Mech

A

Excessive leaflet motion (MVP, flail)

22
Q

Type IIIa and IIIb MR mech

A

IIIa- restricted leaflets in diastole

IIIb- restrict leaflets in systole

23
Q

In type II MR, which way is jet directed?

A

Away from abnormal leaflet

24
Q

Example of type IIIb MR

A

Ischemic

25
Q

What variable on echo determines the natural history CV event rate associated with MR?

A

ERO

26
Q

Class I indication for stage C2 MR?

A

MV surgery

27
Q

What is the treatment algorithm if pt has severe MR (vena contracta >.7, ERO>40, RVol>60) and pt has sxs (Stage D)?

A

See if EF> 30%, if yes, then MV Surgery (I)

If not, IIb

28
Q

What is treatment algorithm for a patient with severe MR (vena contracta >.7, ERO>40, RVol>60), asymptomatic , LVEF 30-69%, LVESD> 40mm?

A

MV Surgery (I)

29
Q

If pt has severe MR (vena contracta >.7, ERO>40, RVol>60) and new AF or PASP> 50 (stage C1), what is treatment algorithm ?

A

MV Repair if likelihood of success is >95% with low mortality (IIa)

30
Q

Treatment algorithm for severe MR, sxs, EF<30% and chordal preservation unlikely

A

Medical Rx

31
Q

for MR, is repair or emplacement preferable?

A

Repair