Cardiac Surgery Certification Exam Cardiac Valve Surgery 2

Question 1

Which hemodynamic finding is characteristic of severe aortic stenosis requiring surgical intervention?

Accepted Answer

Mean aortic valve gradient greater than 40 mmHg with valve area less than 1.0 cm²

Answer

Severe AS is defined by a mean gradient >40 mmHg and aortic valve area <1.0 cm², indicating the need for intervention.

Question 2

The Ross procedure involves:

Accepted Answer

Transferring the patient's own pulmonary valve to the aortic position with a homograft in the pulmonary position

Answer

The Ross procedure replaces the aortic valve with the patient's own pulmonary valve (autograft) and reconstructs the right ventricular outflow with a homograft, providing a living autograft without anticoagulation.

Question 3

The most critical technical step when implanting a mechanical aortic prosthesis to avoid complications is:

Accepted Answer

Secure seating of the sewing ring without paravalvular gaps

Answer

Ensuring complete annular seating without paravalvular gaps prevents paravalvular leak, which can cause hemolysis, heart failure, and need for reoperation.

Question 4

Patient-prosthesis mismatch (PPM) after aortic valve replacement is defined as an effective orifice area index of:

Accepted Answer

Less than 0.85 cm²/m²

Answer

PPM occurs when the effective orifice area index is <0.85 cm²/m², meaning the implanted prosthesis is too small for the patient's body surface area, causing residual obstruction.

Question 5

Which surgical technique can be used to implant a larger aortic prosthesis in patients with a small aortic root?

Accepted Answer

Aortic root enlargement (Nicks or Manouguian procedure)

Answer

Root enlargement procedures like Nicks (extending into the anterior mitral leaflet) or Manouguian (into the aorto-mitral curtain) allow placement of a larger prosthesis.

Cardiac Surgery Certification Exam Practice Test

Cardiac Surgery Certification Exam Practice Test

Cardiac Surgery Certification Exam Cardiac Valve Surgery 2