Prosthetic Valves

Question 1

What angle do the leaflets move between in the St. Jude mechanical valve?

Answer 1

Between 30 and 85 degrees

Question 2

In the mitral position, are mechanical valves usually implanted in the anatomic or antianatomic position?

Answer 2

In the antianatomic position (opening is perpendicular to native MV commissure)

(Blood flow more likely to move leaflets equally and subvalvular apparatus less likely to interfere with leaflets in antianatomic position)

Question 3

St Jude valve vs. On-X valve: echo signatures

Answer 3

St. Jude:
- leaflets hinge above sewing ring
- convergent washing jets

On-X:
- leaflets hinge within plane of sewing ring
- parallel washing jets

Question 4

What is the normal peak velocity for a mechanical/prosthetic aortic valve?

Answer 4

<3m/sec

Question 5

What is the normal mean gradient for a mechanical/prosthetic aortic valve?

Answer 5

MG <20mmHg

Question 6

What is the normal DVI for a mechanical/prosthetic aortic valve?

Answer 6

DVI >/= 0.3

Question 7

What is the normal EOA for a mechanical/prosthetic aortic valve?

Answer 7

EOA >1.2

Question 8

What is the normal AT for a mechanical/prosthetic aortic valve?

Answer 8

AT <80msec

Question 9

What is the normal peak velocity for a prosthetic mitral valve?

Answer 9

<1.9m/sec

Question 10

What is the normal mean gradient for a prosthetic mitral valve?

Answer 10

MG </= 5mmHg

Question 11

What is the normal EOA for a prosthetic mitral valve?

Answer 11

EOA >/= 2.0cm2

Question 12

What is the normal PHT for a prosthetic mitral valve?

Answer 12

<130msec

Question 13

What is the normal peak velocity for a prosthetic tricuspid valve?

Answer 13

<1.7 m/sec

Question 14

What is the normal mean gradient for a prosthetic tricuspid valve?

Answer 14

<6mmHg

Question 15

What is the normal PHT for a prosthetic tricuspid valve?

Answer 15

<230msec

Question 16

What is the most common single tilting disc valve?

Answer 16

Medtronic Hall

Question 17

What is a key feature of the Medtronic Hall valve?

Answer 17

A large central washing jet

Question 18

How much should a watchman device be compressed after expansion of the implant in the LAA?

Answer 18

It should be compressed at 80-92% of its size

Question 19

After watchman placement, what is the maximum acceptable vena contracta of flow in the LAA?

Answer 19

The vena contract should be <0.5cm

Question 20

What width does the LAA ostium need to be (range) in order to place a watchman device?

Answer 20

Between 17 and 31mm