Prognosis of Cardiac Diseases and Procedures

Question 1

What is mortality of Pericardectomy?

Answer 1

10-15% mortality

Question 2

What is complication rate for ICD/Pacemaker implantation?

Answer 2

i. Lead dislodgement 2.3%
ii. Early ICD system infection 1.9%
iii. PTX 0.6%
iv. Device malfunction 0.5%
v. Serious bleeding 0.4%
vi. Venous thrombosis 0.2%
vii. Cardiac perforation 0.1%
viii. Inappropriate shock on follow-up 20% (usually as a consequence of sinus tachycardia or afib

Question 3

What is overall complication rate in PPM implantation?

Answer 3

2-3%

(4-5% for ICD implantation)

Question 4

What is complication rate of PCI?

Answer 4

a. 0.5% risk of major complication such as coronary dissection, MI, perforation, tamponade, stroke.

b. 1% risk of access site bleeding, infection.

Question 5

What is in hospital mortality of cardiogenic shock?

Answer 5

50%

Question 6

What is in hospital mortality of VSR with surgery?

Answer 6

50% (perhaps less with percutaneous closure)

Question 7

Transplant free survival for fulminant myocarditis?

Answer 7

15-20%

Question 8

What is the prognosis and life expectancy for giant cell myocarditis?

Answer 8

10-15% transplant free survival

Median survival 5.5 months

Question 9

What is sudden death per year in asymptomatic severe AI? Symptomatic severe AI?

Answer 9

-4%/ year

-10%/ year

Question 10

What is complication rate in CRTD? Success rate?

Answer 10

-5-10% (RAFT trial)
-90% successful implantation rate

Question 11

What is risk of death in asymptomatic severe AS?

Answer 11

1% / year

Question 12

What is the mortality rate of AVR? AVR + CABG? AVR + MVR?

Answer 12

-2%

-4%

-9%

Question 13

What is the mortality rate of MVR? MVR + CABG?

Answer 13

-5%

-9%

Question 14

What is the mortality rate of Mitral valve repair?

Answer 14

-1%

Question 15

What is complication rate of Pericardiocentesis?

Answer 15

1-2%

Question 16

What is complication rate and complications of the two types of SRT?

Answer 16

Question 17

Review radiation doses of common procedures

Answer 17

Question 18

Mortality rate for acute MR/Mechanical complication in STEMI?

Answer 18

20%

Question 19

Mortality rate for VSR in STEMI?

Answer 19

50% (Higher for Inferobasal)

Question 20

Mortality rate for Free wall rupture?

Answer 20

60% (for those that make it to surgery)

Question 21

Prognosis of Lymphocytic Myocarditis?

Answer 21

80-90% survival with supportive management alone, worse if recurrence, or LV dysfunction, VT

Question 22

Prognosis of endocarditis in hospital and at 1 year?

Answer 22

20% mortality, 40% mortality at 1 year

Question 23

What is prgognosis of Type A Aortic Dissection surgery?

Answer 23

20-30%

Question 24

How to select between Mitral valve repair vs. replacement?

Answer 24

Question 25

What is immunosuppressive regimen for Giant Cell Myocarditis?

Answer 25

-1 gram methylprednisolone x 3 days
-60mg daily followed by 10mg/week taper to a 5mg maintenance dose
-Consider CNI (Tacrolimus, Cyclosporine) and MMF

Question 26

What is immunosuppressive regimen for Sarcoidosis if it presents as GCA?

Answer 26

-1 gram methylprednisolone x 3 days
-60mg daily followed by 10mg/week taper to a 5mg maintenance dose
-Can add on methotrexate

Question 27

What is immunosuppressive regiment for Cardiac Sarcoidosis

Answer 27

Question 28

Prognosis of cardiac sarcoidosis at 1 year, 5 year and 10 years?

Answer 28

Mortality: 10%, 50%, 90%