Prosthetic Valves Flashcards
what scar will usually be found on Px that have had a valve replacement
midline sternotomy scar
what valve replacement/surgery is indicated by a midline sternotomy scar straight down the middle of the sternum (3)
- mitral valve replacement
- aortic valve replacement
- CABG
what type of surgery is less commonly performed for a (minimally invasive) mitral valve replacement surgery
right sided mini thoracotomy
what are the types of prosthetic valve (2), and what is their lifespan (2)
- Bioprosthetic –> 10yrs
- mechanical –> >20yrs
what is the issue w/ mechanical valves
require lifelong anticoagulation with warfarin
what is the INR target range w/ mechanical valves
2.5-3.5
what are the types of mechanical heart valve (3), and describe them (3)
- Starr-Edwards
- -> ball in cage
- Tilting disc
- -> single tilting disc
- St. Jude
- -> two tilting metal discs (bileaflet)
why are Starr-Edwards valves no longer being implanted despite being very successful
highest risk of thrombus formation
which type of mechanical disk has the least risk of thrombus formation
St Jude
outline the major complications of mechanical heart valves (3)
- thrombus
- infective endocarditis
- Haemolysis –> anaemia
in mechanical heart valves what does a click replace for metallic mitral valve and metallic aortic valve respectively (2)
- mitral –> S1
- aortic –> S2
what is TAVI and what is it a treatment for (2)
- transcatheter aortic valve implantation
- treats severe aortic stenosis
what Px usually undergo TAVI
- Px at ^ risk for an open valve replacement operation
how is TAVI performed
- catheter inserted into femoral artery
- feeding wire under X-ray guidance to aortic valve
- inflating balloon stretches stenosed aortic valve
- Bioprosthetic valve implanted in location of aortic valve
is TAVI the first line option in young fit patients…why
No
relatively new procedure so open surgery is still first line option
