Valve replacement

Question 1

causes of valvular disease

Answer 1

• Congenital malformation
• Bacterial endocarditis
• Rheumatic fever … untreated bacterial - 30-40yrs later comes up as valve problem
• Valve prolapse … Chordea tendineae weakens => Regurgitation
• Myocardial infarction

Question 2

Aortic valve stenosis leads to

Answer 2

decr CO, Heart failure
(pressure in the LV incr => myocardial hypertrophy => stiffer heart muscle => high pressure in LA & lungs => eventually, LV dilate & wall thins and systolic function deteriorates)

Question 3

Signs & Symptoms of Aortic stenosis

Answer 3

• Angina
• feeling faint
• SOBOE
• Fatigue
• Heart palpitaion

Question 4

Regurgitation

Answer 4

the valve does not close completely, causing the blood to flow backward through the valve.

Question 5

Cardiopulmonary bypass machine does the role of

Answer 5

heart and lung

cannulae in the superior vena caava => CPB machine oxygenate, filter and pumped => into the aorta.

Question 6

the body is cooled via CPB to reduce

Answer 6

metabolic demands both of the body and the myocardium.

Question 7

Caardioplegic solution (into the coronary arteries)

Answer 7

cools the myocardium further to prevent hypoxic damage as there is no blood flow through the heart

Question 8

Biological valves (from _____ or possibly from _____)

Answer 8

pig pericardium, cadavers (uncommon)

Question 9

BIological valves require ______ term anticoagulation - usually _______, have ______ patency

Answer 9

shorter, 3months, shorter (up to 10yrs)

Question 10

Mechanical valves (prostheses) are _______ anticoagulation, have _____ patency.

Answer 10

lifelong, longer

Question 11

Valvular surgery is seen less and less these days. why?

Answer 11

because it is not common to have rheumatic fever in childhood and also treated well these days

Question 12

Why mechanical valves need lifelong anticoagulation?

Answer 12

because infective bacterial endocarditis can easily happen (high risk)