Evaluation of Prosthetic Mitral Valves: Types and Imaging

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What is the role of TEE in the evaluation of prosthetic mitral valves?

To evaluate left ventricular outflow tract

To evaluate pulmonary regurgitation

To evaluate prosthetic aortic valve regurgitation

To evaluate prosthetic mitral valve function (correct)

What is the abbreviation for Cardiac magnetic resonance?

PET

CHD

ICE

CMR (correct)

What is the abbreviation for Effective orifice area?

EROA

PVR

LVOT

EOA (correct)

What is the role of Doppler echocardiography in mitral valve repair or replacement?

To evaluate mitral valve function Signup and view all the answers

What is the role of CT in the evaluation of prosthetic mitral valves?

To evaluate valve stenosis Signup and view all the answers

What is the purpose of echocardiography in the evaluation of PHVs associated with CHD?

To assess the function of prosthetic valves Signup and view all the answers

Which of the following echocardiographic techniques is used in the evaluation of PHVs associated with CHD?

All of the above Signup and view all the answers

What is the role of Cardiac CT in the evaluation of prosthetic valves in CHD?

To assess the anatomy of the valve Signup and view all the answers

Which modality is used to evaluate prosthetic TV stenosis?

All of the above Signup and view all the answers

What is the purpose of CMR in the evaluation of prosthetic valves?

To evaluate the function of the valve Signup and view all the answers

What is the purpose of comparing a study with a baseline study or serial postoperative studies in evaluating prosthetic valve function?

To assess whether valve function has changed Signup and view all the answers

What is the recommended approach for echocardiographic imaging in patients with prosthetic heart valves?

Standardized measurements according to ASE guidelines Signup and view all the answers

What is the significance of including heart rate in the report when evaluating prosthetic valve function?

It affects the duration of diastolic filling and mean gradients Signup and view all the answers

What is the reported prevalence of prosthetic valve dysfunction?

3.6% to 40% Signup and view all the answers

Why is TEE frequently needed in addition to transthoracic Doppler?

For a more definitive assessment of valvular regurgitation in mitral and tricuspid prosthesis Signup and view all the answers

What is the most common cause of bioprosthesis degeneration?

Valve calcification Signup and view all the answers

What is the primary site of calcification in bioprosthesis?

Leaflets and stents Signup and view all the answers

What is the failure rate of homografts at 10 to 15 years?

10% to 20% Signup and view all the answers

What is the term for intrinsic permanent changes to the prosthetic valve?

SVD Signup and view all the answers

What is the term for a valve that is expanded using a balloon?

Balloon-expandable valve Signup and view all the answers

Which type of echocardiography is used during percutaneous prosthetic valve replacement?

Transesophageal echocardiography Signup and view all the answers

What is the term for the mismatch between the size of the prosthetic valve and the patient's anatomy?

Prosthesis-patient mismatch Signup and view all the answers

What is the primary role of Doppler echocardiography in the evaluation of prosthetic aortic valves?

To measure gradients across prosthetic valves Signup and view all the answers

Which imaging modality is used to evaluate prosthetic valve thrombosis?

Echocardiography Signup and view all the answers

What is the term for the normal backflow of blood through a prosthetic valve?

Physiologic regurgitation Signup and view all the answers

Which echocardiographic technique is used to guide percutaneous prosthetic valve replacement?

Transesophageal echocardiography Signup and view all the answers

What is the term for the abnormal narrowing of a prosthetic valve?

Stenosis Signup and view all the answers

Which modality is used to evaluate prosthetic valve function in patients with CHD?

Cardiac magnetic resonance imaging (CMR) Signup and view all the answers

What is the term for the leak between a prosthetic valve and the surrounding tissue?

Paravalvular leak Signup and view all the answers

Which echocardiographic technique is used to measure gradients across prosthetic valves?

Doppler echocardiography Signup and view all the answers

In patients with significant cardiac valvular disease, what may be inevitable?

Intervention with either valve repair or valve replacement Signup and view all the answers

Which valves are more frequently repaired?

Mitral and tricuspid valves Signup and view all the answers

Why are diagnostic methods needed in patients with prosthetic valves?

To assess the function of the prosthesis Signup and view all the answers

What is commonly performed in adults especially?

Valve replacement Signup and view all the answers

What is the role of echocardiography in patients with prosthetic valves?

To assess the function of the prosthesis Signup and view all the answers

Which type of prosthetic valve is more thrombogenic according to the text?

Mechanical valves Signup and view all the answers

Which valve is affected more frequently by thrombosis compared to left-sided valves?

Tricuspid valve Signup and view all the answers

How is thrombus on bioprosthetic valves described in CT imaging?

Hypoattenuated leaflet thickening Signup and view all the answers

Which of the following is NOT listed as an essential parameter for the evaluation of prosthetic valve function in the text?

Joint velocity signal analysis Signup and view all the answers

What may thrombus be associated with when seen on echocardiography?

Intracardiac thrombus Signup and view all the answers

What are some of the common causes of structural prosthetic heart valve (PHV) dysfunction?

Endocarditis and CT imaging Signup and view all the answers

What is the main difference between physiologic and pathologic prosthetic regurgitation?

Severity of regurgitation Signup and view all the answers

What common issue can cause pressure recovery in the context of prosthetic valves?

Prosthesis size Signup and view all the answers

In the context of prosthetic valve function, what does the term 'nonstructural valve dysfunction' refer to?

Patient-prosthesis size mismatch Signup and view all the answers

What is a potential consequence of paravalvular leak in prosthetic valves?

Increased transvalvular regurgitation Signup and view all the answers

How does prosthesis-patient mismatch affect the hemodynamic performance of prosthetic valves?

Causes stenosis Signup and view all the answers

What imaging modality is considered less sensitive for the detection of valvular regurgitation in mitral and tricuspid prostheses?

Transthoracic Doppler Signup and view all the answers

What impact does hypoattenuation affecting motion have on prosthetic heart valves?

Reduces valve motion Signup and view all the answers

What is a key parameter for determining whether prosthetic valve function has changed?

Clinical information Signup and view all the answers

What is included in echocardiographic imaging recommendations for patients with prosthetic heart valves?

Measurements of cardiac chambers and function Signup and view all the answers

Why should body surface area be included in the assessment of prosthetic heart valves?

To assess the presence of PPM Signup and view all the answers

What is the significance of mild thickening in a biologic valve?

It suggests nonstructural valve failure Signup and view all the answers

In the aortic position, what does independent or rocking motion of a replacement valve indicate?

Nonstructural valve failure Signup and view all the answers

What does increased mobility of a valve in the mitral position potentially indicate?

Nonstructural valve dysfunction Signup and view all the answers

Thickening of the aortic root post-stentless valve insertion can be mistaken for what condition?

Abscess Signup and view all the answers

What is the potential consequence of rocking motion in a replacement valve?

Nonstructural valve dysfunction Signup and view all the answers

Why might off-axis imaging be necessary to visualize the central occluder or leaflets of the prosthetic valve?

Nonstructural valve failure Signup and view all the answers

What is the diagnostic significance of biplane imaging in the evaluation of a prosthetic valve?

Localization of paravalvular regurgitation Signup and view all the answers

What sign in the mitral valve needs to be differentiated to not mistake it for dehiscence?

Absence of PVL Signup and view all the answers

What is the best approach to differentiate thickening due to hematoma from a potential aortic root abscess?

Review postoperative imaging Signup and view all the answers

What lasting sign in a stentless valve could potentially be mistaken for an abscess?

Thickening of the aortic root Signup and view all the answers

What is a key parameter for determining prosthetic valve function changes?

Effective orifice area Signup and view all the answers

In which type of prosthetic valves could overestimation of the gradient occur, especially with smaller valves and high cardiac output?

Mechanical bileaflet prostheses Signup and view all the answers

What equation should be used to estimate the pressure gradient in patients with aortic prostheses and high cardiac output or narrow LVOT when V1 > 1.5 m/sec?

DP = 4(V2² - V1²) Signup and view all the answers

Which condition may be inevitable in patients with high cardiac output and narrow LVOT in aortic prostheses?

Pressure recovery Signup and view all the answers

Which type of valve may experience more overestimation of the gradient than others, particularly with specific conditions?

Caged-ball valves Signup and view all the answers

Which category of prosthetic valve dysfunction involves intrinsic permanent changes to the valve, such as leaflet disruption or stent fracture?

Structural valve dysfunction (SVD) Signup and view all the answers

What is the most common cause of bioprosthesis degeneration in prosthetic valves?

Valve calcification Signup and view all the answers

In prosthetic heart valves, where is valve calcification most commonly found?

In the stent or strut Signup and view all the answers

What is the term used for changes to a prosthetic valve that are temporary and reversible, not involving permanent alterations to the valve structure?

Nonstructural valve dysfunction Signup and view all the answers

In prosthetic valves, which type of valve dysfunction is more common in bioprosthetic valves compared to mechanical prostheses?

Structural valve dysfunction (SVD) Signup and view all the answers

Evaluation of Prosthetic Mitral Valves: Types and Imaging

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Questions and Answers

What is the role of TEE in the evaluation of prosthetic mitral valves?

What is the abbreviation for Cardiac magnetic resonance?

What is the abbreviation for Effective orifice area?

What is the role of Doppler echocardiography in mitral valve repair or replacement?

What is the role of CT in the evaluation of prosthetic mitral valves?

What is the purpose of echocardiography in the evaluation of PHVs associated with CHD?

Which of the following echocardiographic techniques is used in the evaluation of PHVs associated with CHD?

What is the role of Cardiac CT in the evaluation of prosthetic valves in CHD?

Which modality is used to evaluate prosthetic TV stenosis?

What is the purpose of CMR in the evaluation of prosthetic valves?

What is the purpose of comparing a study with a baseline study or serial postoperative studies in evaluating prosthetic valve function?

What is the recommended approach for echocardiographic imaging in patients with prosthetic heart valves?

What is the significance of including heart rate in the report when evaluating prosthetic valve function?

What is the reported prevalence of prosthetic valve dysfunction?

Why is TEE frequently needed in addition to transthoracic Doppler?

What is the most common cause of bioprosthesis degeneration?

What is the primary site of calcification in bioprosthesis?

What is the failure rate of homografts at 10 to 15 years?

What is the term for intrinsic permanent changes to the prosthetic valve?

What is the term for a valve that is expanded using a balloon?

Which type of echocardiography is used during percutaneous prosthetic valve replacement?

What is the term for the mismatch between the size of the prosthetic valve and the patient's anatomy?

What is the primary role of Doppler echocardiography in the evaluation of prosthetic aortic valves?

Which imaging modality is used to evaluate prosthetic valve thrombosis?

What is the term for the normal backflow of blood through a prosthetic valve?

Which echocardiographic technique is used to guide percutaneous prosthetic valve replacement?

What is the term for the abnormal narrowing of a prosthetic valve?

Which modality is used to evaluate prosthetic valve function in patients with CHD?

What is the term for the leak between a prosthetic valve and the surrounding tissue?

Which echocardiographic technique is used to measure gradients across prosthetic valves?

In patients with significant cardiac valvular disease, what may be inevitable?

Which valves are more frequently repaired?

Why are diagnostic methods needed in patients with prosthetic valves?

What is commonly performed in adults especially?

What is the role of echocardiography in patients with prosthetic valves?

Which type of prosthetic valve is more thrombogenic according to the text?

Which valve is affected more frequently by thrombosis compared to left-sided valves?

How is thrombus on bioprosthetic valves described in CT imaging?

Which of the following is NOT listed as an essential parameter for the evaluation of prosthetic valve function in the text?

What may thrombus be associated with when seen on echocardiography?

What are some of the common causes of structural prosthetic heart valve (PHV) dysfunction?

What is the main difference between physiologic and pathologic prosthetic regurgitation?

What common issue can cause pressure recovery in the context of prosthetic valves?

In the context of prosthetic valve function, what does the term 'nonstructural valve dysfunction' refer to?

What is a potential consequence of paravalvular leak in prosthetic valves?

How does prosthesis-patient mismatch affect the hemodynamic performance of prosthetic valves?

What imaging modality is considered less sensitive for the detection of valvular regurgitation in mitral and tricuspid prostheses?

What impact does hypoattenuation affecting motion have on prosthetic heart valves?

What is a key parameter for determining whether prosthetic valve function has changed?

What is included in echocardiographic imaging recommendations for patients with prosthetic heart valves?

Why should body surface area be included in the assessment of prosthetic heart valves?

What is the significance of mild thickening in a biologic valve?

In the aortic position, what does independent or rocking motion of a replacement valve indicate?

What does increased mobility of a valve in the mitral position potentially indicate?

Thickening of the aortic root post-stentless valve insertion can be mistaken for what condition?

What is the potential consequence of rocking motion in a replacement valve?

Why might off-axis imaging be necessary to visualize the central occluder or leaflets of the prosthetic valve?

What is the diagnostic significance of biplane imaging in the evaluation of a prosthetic valve?

What sign in the mitral valve needs to be differentiated to not mistake it for dehiscence?

What is the best approach to differentiate thickening due to hematoma from a potential aortic root abscess?

What lasting sign in a stentless valve could potentially be mistaken for an abscess?

What is a key parameter for determining prosthetic valve function changes?

In which type of prosthetic valves could overestimation of the gradient occur, especially with smaller valves and high cardiac output?

What equation should be used to estimate the pressure gradient in patients with aortic prostheses and high cardiac output or narrow LVOT when V1 > 1.5 m/sec?

Which condition may be inevitable in patients with high cardiac output and narrow LVOT in aortic prostheses?

Which type of valve may experience more overestimation of the gradient than others, particularly with specific conditions?

Which category of prosthetic valve dysfunction involves intrinsic permanent changes to the valve, such as leaflet disruption or stent fracture?

What is the most common cause of bioprosthesis degeneration in prosthetic valves?

In prosthetic heart valves, where is valve calcification most commonly found?

What is the term used for changes to a prosthetic valve that are temporary and reversible, not involving permanent alterations to the valve structure?

In prosthetic valves, which type of valve dysfunction is more common in bioprosthetic valves compared to mechanical prostheses?

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