Mitral Valves Flashcards
Which MV leaflet has larger surface area but occupies only 1/3 of annulus?
Anterior
Which MV leaflet has smaller surface area but occupies 2/3 of the annulus?
Posterior leaflet
What to look for opinion cath tracings for MS?
At diastole, LAP»LVP
What valve area, mean gradient, and systolic PAP defines moderate MS?
MVA: 1-1.5cm
Mean grad : 5-10
PAP: 30-50
What stage of MS is asymptomatic, MVA150ms, severe LAE?
C
What stage of MS is symptomatic, MVA150ms, severe LAE?
D
What does it mean when opening snap in MS is early?
MS is severe
If a pt with MS develops Pulm HTN, what is their median survival in years?
<3 y
Besides MV replacement, what is a surgery for MS?
Mitral commissurotomy
Wilkins score for MS gives 4 points to each of the following:
- leaflet thickening
- leaflet calcification
- leaflet mobility
- subvalvular thickening
What MVA is considered severe MS?
<1.5cm
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?
See if PCWP >25 with exercise, and if so, you can do PMBC (IIb)
What ERO and Regurgitant Volume define severe MR?
ERO> 40
RVol> 60
With normal LA and LV, can MR be severe?
No
Causes of MR
Rupture (Pap m, chordal, leaflet) Endocarditis MVP ischemia Rheumatic
In acute MR, how loud will murmur be?
Soft
What stage if MR is asymptomatic, severe (jet area >40% LA, RVol>60cc, ERO>.4, LAE, PHTN) and EF>60%/LVESD<40mm?
C1
What stage if MR is asymptomatic, severe (jet area >40% LA, RVol>60cc, ERO>.4, LAE, PHTN) and EF40mm?
C2
What stage of MR is severe, sxs (dec ET)?
D
Type I MR mech
Annular dilatation
Type II MR Mech
Excessive leaflet motion (MVP, flail)
Type IIIa and IIIb MR mech
IIIa- restricted leaflets in diastole
IIIb- restrict leaflets in systole
In type II MR, which way is jet directed?
Away from abnormal leaflet
Example of type IIIb MR
Ischemic
What variable on echo determines the natural history CV event rate associated with MR?
ERO
Class I indication for stage C2 MR?
MV surgery
What is the treatment algorithm if pt has severe MR (vena contracta >.7, ERO>40, RVol>60) and pt has sxs (Stage D)?
See if EF> 30%, if yes, then MV Surgery (I)
If not, IIb
What is treatment algorithm for a patient with severe MR (vena contracta >.7, ERO>40, RVol>60), asymptomatic , LVEF 30-69%, LVESD> 40mm?
MV Surgery (I)
If pt has severe MR (vena contracta >.7, ERO>40, RVol>60) and new AF or PASP> 50 (stage C1), what is treatment algorithm ?
MV Repair if likelihood of success is >95% with low mortality (IIa)
Treatment algorithm for severe MR, sxs, EF<30% and chordal preservation unlikely
Medical Rx
for MR, is repair or emplacement preferable?
Repair
Whi regards to MV segments, which one is medial and which is lateral?
Medial= 3 Lateral = 1
