CCI Valvular Pathology Assessment 5

Question 1

A patient with mitral valve prolapse and a flail posterior leaflet has a regurgitant volume of 72 mL/beat. According to ASE guidelines, this represents:

Accepted Answer

Severe mitral regurgitation (≥60 mL/beat)

Answer

Regurgitant volume ≥60 mL per beat meets the quantitative threshold for severe mitral regurgitation according to 2017 ASE valve guidelines.

Question 2

Which of the following is the most common cause of aortic stenosis in patients younger than 70 years in the United States?

Accepted Answer

Bicuspid aortic valve disease

Answer

Bicuspid aortic valve, occurring in 1–2% of the population, is the most common cause of aortic stenosis requiring surgery in patients under 70 years of age in developed countries.

Question 3

In assessing pulmonic stenosis severity, a peak instantaneous Doppler gradient of 65 mmHg indicates:

Accepted Answer

Severe pulmonic stenosis (>64 mmHg)

Answer

A peak gradient exceeding 64 mmHg defines severe pulmonic stenosis; these patients typically qualify for percutaneous balloon pulmonic valvuloplasty.

Question 4

Which finding on intraoperative transesophageal echocardiography (TEE) after mitral valve repair would prompt the surgeon to return to bypass for revision?

Accepted Answer

Residual mitral regurgitation >2+ (moderate or greater)

Answer

Residual MR of moderate or greater severity (>2+) after mitral repair is an indication to return to cardiopulmonary bypass for revision, as significant residual MR predicts early repair failure.

Question 5

In a patient with suspected aortic stenosis and atrial fibrillation, which adaptation to the Doppler technique improves AVA accuracy?

Accepted Answer

Averaging gradients and VTI over at least 5 cardiac cycles to account for beat-to-beat variability

Answer

In atrial fibrillation, stroke volume varies cycle to cycle; averaging Doppler measurements over a minimum of 5 beats reduces variability and improves reliability of the continuity equation AVA.

CCI - Cardiovascular Credentialing International Practice Test

CCI - Cardiovascular Credentialing International Practice Test

CCI Valvular Pathology Assessment 5