Valve Replacement and Congenital Disease Flashcards

1
Q

what are the advantages and disadvantages of a mechanical valve?

A

advantage is that they last forever

disadvantage is that the patient requires anticoagulation for the remainder of their lives

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2
Q

what are the advantages and disadvantages of bioprosthetic valves?

A

advantage is that anticoagulation is not needed

disadvantage is that they wear out after 12-15 years

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3
Q

what is the EBL for a mitral valve replacement?

A

300-400 mL

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4
Q

how do patients with mitral regurgitation and mitral stenosis react postoperatively?

A

MR patients usually do well, and require minimal inotropes

MS patients may require significant inotropes

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5
Q

which patients generally have a better prognosis, those with aortic regurgitation or those with aortic stenosis?

A

aortic stenosis

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6
Q

what are the three types of shunts?

A

simple
bidirectional
complex

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7
Q

what five lesions are characterized by excessive pulmonary blood flow?

A
atrial septal defect
ventricular septal defect
atrioventricular septal defect
truncus arteriosus 
hypoplastic left heart
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8
Q

what four lesions are characterized by inadequate pulmonary blood flow?

A

transposition of great vessels

TOF

tricuspid atresia

total anomalous pulmonary venous return

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9
Q

in patients with coarctation of the aorta, where are they hypertensive and where are they hypotensive?

A

they are hypertensive in the upper body, and hypotensive in the lower body

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10
Q

what should be done with the ductus arteriosus in patients with coarctation of the aorta?

A

keep it open with PGE1

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11
Q

what are three ways to lower CHF in a neonate?

A

PGE1 to open PDA
PPV
diuretics

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12
Q

where should the BP cuff be placed in a patient with coarctation of the aorta?

A

lower extremity

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13
Q

what should be expected in an ABG after cross-clamp release?

A

acidosis

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14
Q

what is post-coarctectomy syndrome?

A

abdominal pain
abdominal distension
N/V
hypertension

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15
Q

what is Marfan syndrome?

A

a disorder of connective tissue, a defect of collagen synthesis that decreases connective tissue strength and elasticity

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16
Q

Marfan syndrome is a mutation in what gene?

A

FBNI

17
Q

what are three physical symptoms of Marfan syndrome?

A

pectus excavatum
arachnodactyly
dilation of the aorta

18
Q

what is a big intraoperative risk for patients with Marfan syndrome?

A

aortic arch dissection

they also have mitral or aortic valve regurg

19
Q

what two preoperative medications should be given to patients with Marfan syndrome?

A

SBE prophylaxis

beta blockers, to prevent increased inotopy and aortic wall tension

20
Q

why should you be careful positioning patients with Marfan syndrome?

A

high risk of dislocation

21
Q

what are two airway abnormalities in patients with Marfan syndrome?

A

high arched palate

cervical instability