Cardiac Valve Surgery Flashcards

The standard surgical approach for isolated mitral valve surgery in most US centers is:

Answer: Median sternotomy with left atriotomy via the interatrial groove

Median sternotomy with access through the left atrium via the interatrial (Sondergaard) groove is the standard approach for most mitral valve operations.

Which feature of a bioprosthetic heart valve is its primary advantage over a mechanical valve?

Answer: Does not require lifelong anticoagulation

Bioprosthetic valves do not require long-term anticoagulation after the initial postoperative period, reducing hemorrhagic risks for appropriate patients.

The most common cause of mitral valve regurgitation requiring surgery in the United States is:

Answer: Myxomatous mitral valve disease (mitral valve prolapse)

Myxomatous degeneration (Barlow's disease or fibro-elastic deficiency) causing mitral valve prolapse is the leading cause of surgical mitral regurgitation in the US.

What is the preferred surgical option for mitral regurgitation due to posterior leaflet prolapse with good tissue quality?

Answer: Mitral valve repair

Mitral valve repair is the gold standard for posterior leaflet prolapse because it preserves native tissue, avoids prosthetic valve risks, and provides excellent long-term outcomes.

The annuloplasty ring used in mitral valve repair serves primarily to:

Answer: Remodel and stabilize the mitral annulus to prevent recurrent regurgitation

The annuloplasty ring reshapes and downsizes the dilated mitral annulus, ensuring leaflet coaptation and long-term repair durability.

Intraoperative TEE after mitral valve repair is used primarily to:

Answer: Assess residual regurgitation and confirm adequate valve function before chest closure

Post-repair TEE immediately identifies residual or new regurgitation, stenosis, or systolic anterior motion, allowing the surgeon to revise the repair before leaving the OR.