Cardiac Valve Surgery Flashcards
6 cards from real CSC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Cardiac Valve Surgery flashcards as text
Which hemodynamic finding is characteristic of severe aortic stenosis requiring surgical intervention?
Answer: Mean aortic valve gradient greater than 40 mmHg with valve area less than 1.0 cm²
Severe AS is defined by a mean gradient >40 mmHg and aortic valve area <1.0 cm², indicating the need for intervention.
The Ross procedure involves:
Answer: Transferring the patient's own pulmonary valve to the aortic position with a homograft in the pulmonary position
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.
The most critical technical step when implanting a mechanical aortic prosthesis to avoid complications is:
Answer: Secure seating of the sewing ring without paravalvular gaps
Ensuring complete annular seating without paravalvular gaps prevents paravalvular leak, which can cause hemolysis, heart failure, and need for reoperation.
Patient-prosthesis mismatch (PPM) after aortic valve replacement is defined as an effective orifice area index of:
Answer: Less than 0.85 cm²/m²
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.
Which surgical technique can be used to implant a larger aortic prosthesis in patients with a small aortic root?
Answer: Aortic root enlargement (Nicks or Manouguian procedure)
Root enlargement procedures like Nicks (extending into the anterior mitral leaflet) or Manouguian (into the aorto-mitral curtain) allow placement of a larger prosthesis.
Which complication of aortic valve replacement requires emergency reoperation and presents with severe new aortic regurgitation immediately post-bypass?
Answer: Prosthetic valve malposition or paravalvular leak
Significant paravalvular leak or prosthetic malposition producing severe acute aortic regurgitation after bypass requires immediate return to CPB for revision.