CCS Cardiovascular Treatment Procedures 5

Question 1

The MitraClip procedure treats mitral regurgitation by:

Accepted Answer

Clipping the mitral leaflets together to create a double-orifice valve

Answer

The MitraClip grasps and approximates the anterior and posterior mitral leaflets at the regurgitant jet, reducing MR by creating a double-orifice configuration.

Question 2

During PCI of a chronic total occlusion (CTO), which crossing technique involves advancing a wire through the subintimal space and re-entering the true lumen distal to the occlusion?

Accepted Answer

Subintimal tracking and re-entry (STAR technique)

Answer

The STAR technique intentionally creates a subintimal channel and uses re-entry devices to regain the true lumen distal to a CTO.

Question 3

Left atrial appendage (LAA) occlusion with the Watchman device is used as an alternative to long-term anticoagulation in patients with atrial fibrillation who have:

Accepted Answer

High stroke risk but contraindication to long-term anticoagulation

Answer

The Watchman device seals off the LAA (source of ~90% of AF-related thrombi) in patients with elevated stroke risk who cannot safely take oral anticoagulants.

Question 4

Which measure is used to assess the physiologic significance of a coronary stenosis using a pressure wire, without administering hyperemic agents?

Accepted Answer

Instantaneous wave-free ratio (iFR)

Answer

iFR is measured during the diastolic wave-free period when microvascular resistance is naturally minimal, allowing lesion assessment without adenosine.

Question 5

A patient receiving thrombolytic therapy for STEMI develops sudden neurologic deficits 2 hours after drug administration. The most likely diagnosis is:

Accepted Answer

Intracranial hemorrhage

Answer

Intracranial hemorrhage is the most feared complication of thrombolytic therapy, occurring in approximately 0.5–1% of cases, and presents with acute neurologic deterioration.

(CCS) Certified Cardiovascular Specialist Practice Test

(CCS) Certified Cardiovascular Specialist Practice Test

CCS Cardiovascular Treatment Procedures 5