Prosthetic Valves

Front 1

what is the most common disease that attacks the valves

Back 1

rheumatic fever
- attacks MV

Front 2

2 Categories of prosthetic valves

Back 2

Biological valves
mechanical valves

Front 3

Biological valves

Back 3

aka tissue valves
bascially a valve or tissue constructed into a valve from a animal or a human tissue

Front 4

mechanical valves

Back 4

are made non-biological material

Front 5

Mechanical valves made with

Back 5

titanium
metal
plastic

Front 6

mechanical valves require pt to be on

Back 6

anticoagulation therapy
why? to prevent thrombosis

Front 7

Ball and cage

Back 7

starr Edward's valve

Front 8

st judes

Back 8

2 tilting disc

Front 9

Bjork shiley

Back 9

1tilting disc

Front 10

Tissue valves
1. heterographs
2. homographes

Back 10

hetero- animals
homo- human
tissue valves are less likely to have thrombosis but they are less durable than a mechanical valve

Front 11

1.tissue valve will last ------- than machancial valves
2. tissue valves usually develop -------- in 10-15 yrs
3. constructed with ----

Back 11

1. shorter than
2. stenosis or regurg
3. tissue valves usually have three cups attached to 2 metal stents

Front 12

ALL prosethetic valves will have

Back 12

Narrower orifice than native valve

Front 13

Prosthetic valves have

Back 13

1. higher velocity
2. stenotic
3. you can hear a click nosing (audible clicks)

Front 14

2D assessing pts with prosthetic valves (4)

Back 14

1. look anatomy
2. function
3. infection
4. thrombosis

Front 15

2D look at anatomy

Back 15

is there calcification
degeneration (can it break)
DEHISCENCE

Front 16

Dehiscence

Back 16

is when the sewing ring either the stitches get loose or it starts to separate fromt he actual pt

- you will see leakage around the valve (PARAVALUAR)
- rocking motion of the valve - its looks its not set in place

Front 17

Function 2D prosthetic valve

Back 17

is there obstruction
is there regurg through the valve
paravalvuar caused by calcification, degeneration, dehiscence

Front 18

infection 2D prosthetic valve

Back 18

infection of the valve it self
paravalvuer abscess

Front 19

thrombosis 2D assess of prosthetic valve

Back 19

on the replaced valve

Front 20

Baseline Study is done when

Back 20

right ater pts get there valve replacement

Front 21

tend to do a lot of TEE pts with

Back 21

Mitral valve replacement

Front 22

what is very useful in evaluating prosthetic valves?

Back 22

Doppler
spectral doppler will be more sensitive than color flow

Front 23

1. MV velocity should still be -------- Aortic valve velocity
2. smaller valves sizes have ------ velocity
3. AV peak velocity should be less than
4. peak velocity greater than 2m/s in MV usually indicates
5. can use the ----- to look at valve orifice area

Back 23

1. less than
2. increase
3. 3m/s
4. dysfunction both mechanical and biological prosthetic valves
5. continuity eq

Front 24

nearly all mechanical valves have some degree of

Back 24

regurgitation

Front 25

Physiological regurgitation

Back 25

originates within the sewing ring
-typical patterns for each valve type
- bileaflet- 3 jets
- single leaflet - 2 jets

Front 26

pathologic regurgitation

Back 26

-characterized by: large jet, eccentric jet, variacne of color flow
-the jet can be evaluated with CW
-turbulent forward flow- refers to as mosaic - alot of different colors

Front 27

mechanical valves - pathologic

Back 27

will look more
-bigger
-abnormal patterns
-more velocity

Front 28

if there is a suspected problem (3)

Back 28

1. compare it to the post-op baseline study
-what it used to look like
2. look for abnormality in 2D & m-mode
-look at sutrues
- thrombosis , vegetations, calcifications
3. hemodynamic problems
-look for color flow & use spectral doppler

Front 29

if you see paravalvuar regurg outside the valve, abnormal= caused by

Back 29

endocarditis
abscess
dischenece

Front 30

endocarditis on prosthetic valve

Back 30

serious complication
treat pt with antibiotics
replace the valve

Front 31

What is endocarditis

Back 31

infected inflammatory bacterium sits on endocardium
-can manifest itself into vegtations
- bacteria sits on the valve, grows causes incomplete closure of the valve
- abscess can be see as a hypoechic around the valve
- M-mode can see thickening of valve
-tee for endocarditis

Front 32

Thrombosis

Back 32

more common mechanical valve
dilated cardiac CH and stasis of the blood and poor LV function

Front 33

Anticoagulation is essential for

Back 33

ALL mechanical valves

Front 34

Prosthetic valves risk of thrombosis is related to

Back 34

pressure gradient changes

Front 35

Which valve is more likely to develop thrombus

Back 35

the lover the pressure gradient the higher chance to have thrombus
1. Tricuspid
2. mitral
3. pulmonic
4. aortic

Front 36

On echo Thrombus -

Back 36

- mobile mass
- reduce or absent motion of mobile part of the valvee
-associated dilatation of the CH
- Thrombus ont he valve replacement is acting like a obstruction Causing CH to dilate

Front 37

Variance of the Mechanical valve

Back 37

can cause obstruction or regurg of a calve

Front 38

What is variance

Back 38

change in size of the mechanical valve 2ndary to cracks
- it can degenrate it can break
cracked- variance can cause OBSTRUCTION and Regurg
- breaking down or shrinking

Front 39

degeneration - biological valves

Back 39

stenosis
calcification
rupture

Front 40

PHT will --- the prosethic valve

Back 40

overestimate
must use continuity eq

Front 41

Things that can go wrong with prostheic valves

Back 41

dehiscence
crack - variance
vegetation
thrombus
stenosis/regurgitation
inflammation of the tissue attached too