Cardiac Surgery Certification Exam Cardiac Valve Surgery 3

Question 1

Which finding on intraoperative TEE after mitral valve repair suggests systolic anterior motion (SAM) of the mitral valve?

Accepted Answer

Anterior displacement of the anterior mitral leaflet into the LVOT with dynamic obstruction

Answer

Posterior leaflet coaptation failure

Answer

Aortic regurgitation

Answer

Mitral annular calcification

Question 2

The Carpentier functional classification Type I mitral regurgitation is characterized by:

Accepted Answer

Normal leaflet motion with annular dilation or leaflet perforation

Answer

Leaflet prolapse with excess motion

Answer

Restricted leaflet motion due to rheumatic disease

Answer

Ischemic tethering of the leaflets

Question 3

The primary indication for tricuspid valve repair at the time of left-sided valve surgery is:

Accepted Answer

Tricuspid annular dilation greater than 40 mm or moderate-severe functional tricuspid regurgitation

Answer

Any degree of tricuspid regurgitation

Answer

Isolated TR without annular dilation

Answer

Right ventricular dilation alone

Question 4

Which valve lesion typically presents with the longest asymptomatic period, delaying the need for surgery?

Accepted Answer

Chronic aortic regurgitation

Answer

Acute mitral regurgitation

Answer

Severe mitral stenosis

Answer

Severe aortic stenosis

Question 5

What is the most common cause of bioprosthetic valve failure requiring reoperation?

Accepted Answer

Structural valve deterioration (calcification and leaflet tears)

Answer

Prosthetic valve endocarditis

Answer

Thrombosis

Answer

Paravalvular leak

Question 6

After mechanical heart valve replacement, the target INR for a bileaflet mechanical aortic valve in a low-risk patient is:

Accepted Answer

2.0–3.0

Answer

3.0–4.0

Answer

1.5–2.0

Answer

4.0–5.0