Prosthetic Valves

Question 1

What scars may be visible following a prosthetic valve replacement?

Answer 1

Midline sternotomy scar (could also be a CABG)

Right-sided mini thoracotomy incision (only for mitral valve replacement)

Question 2

What are the two types of prosthetic heart valve?

Answer 2

Bio-prosthetic

Mechanical

Question 3

What is the lifespan of bio-prosthetic valves?

Answer 3

10 years

Question 4

What is the lifespan of mechanical valves?

Answer 4

> 20 years

Question 5

Which valve type requires anticoagulation?

Answer 5

Mechanical (with warfarin)

Question 6

What is the INR target range with mechanical valves?

Answer 6

2.5-3.5

Question 7

What are the different types of mechanical valve?

Answer 7

Starr-Edwards valve (ball in a cage - no longer used due to thrombus risk)
Tilting disc valve
Saint Judes valve (2 tilting metal discs - bi-leaflet valve)

Question 8

Which type of mechanical heart valve has the lowest risk of thrombus formation?

Answer 8

Saint Judes valve

Question 9

What are the major complications of mechanical heart valves?

Answer 9

Thrombus formation
Infective endocarditis
Haemolysis

Question 10

What may be heard when auscultating a patient’s mechanical heart valve?

Answer 10

A click

This will replace S1 if the valve is in mitral position, or S2 if in the aortic position

Question 11

What is a TAVI?

Answer 11

Trans-catheter aortic valve implantation

Question 12

What percentage of patients with a surgical valve replacement will experience infective endocarditis?

Answer 12

2.5%

Question 13

What is the mortality rate of infective endocarditis of a prosthetic valve?

Answer 13

15%

Question 14

What are the most common causes of infective endocarditis?

Answer 14

Staphylococcus
Streptococcus
Enterococcus