Valve Replacement Flashcards
When is a stenotic valve replaced?
With severe disease
When is a regurgitant valve replaced?
With decompensation
Which valve is usually replaced and which is repaired or replaced
Aortic valves is usually replaced
Mitral valve is repaired or replaced
What can cause an emergent aortic valve replacement?
Acute regurg.
- aortic dissection can causes MR
- trauma or aneurysm
What occurs due to the acute AR?
LV overload leads to LV failure
How is stabilization done until valve can be replaced?
Aggressive vasodilation
Inotropes only appropriate if surgery is immediate
-Contractility increase worsens dissection
How long to mechanical valves last?
20-30 years
What is required with mechanical valves?
Anticoagulants
How long do biological valves last?
Half as long as mechanical valves
If pt has had a valve replacement what should be done for subsequent surgeries with anticoagulant?
Off anticoagulation for minor surgery
Change to heparin for less minor
Minimally invasive valve
Smaller incision Normothermia CPB Endoscopic +/- Robotic One lung anesthesia for some approaches
Percutaneous procedures
Transcatheter AVR Percutaneous mitral valve repair Avoids stern onto my and CPB General anesthesia and fluoroscopy A-line, PAC, transcutaneous pacemaker for TAVR
