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?

  • 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?

<p>To evaluate mitral valve function (C)</p> Signup and view all the answers

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

<p>To evaluate valve stenosis (B)</p> Signup and view all the answers

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

<p>To assess the function of prosthetic valves (A)</p> Signup and view all the answers

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

<p>All of the above (D)</p> Signup and view all the answers

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

<p>To assess the anatomy of the valve (D)</p> Signup and view all the answers

Which modality is used to evaluate prosthetic TV stenosis?

<p>All of the above (D)</p> Signup and view all the answers

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

<p>To evaluate the function of the valve (D)</p> 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?

<p>To assess whether valve function has changed (B)</p> Signup and view all the answers

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

<p>Standardized measurements according to ASE guidelines (A)</p> Signup and view all the answers

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

<p>It affects the duration of diastolic filling and mean gradients (B)</p> Signup and view all the answers

What is the reported prevalence of prosthetic valve dysfunction?

<p>3.6% to 40% (C)</p> Signup and view all the answers

Why is TEE frequently needed in addition to transthoracic Doppler?

<p>For a more definitive assessment of valvular regurgitation in mitral and tricuspid prosthesis (D)</p> Signup and view all the answers

What is the most common cause of bioprosthesis degeneration?

<p>Valve calcification (C)</p> Signup and view all the answers

What is the primary site of calcification in bioprosthesis?

<p>Leaflets and stents (C)</p> Signup and view all the answers

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

<p>10% to 20% (B)</p> Signup and view all the answers

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

<p>SVD (D)</p> Signup and view all the answers

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

<p>Balloon-expandable valve (B)</p> Signup and view all the answers

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

<p>Transesophageal echocardiography (C)</p> 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?

<p>Prosthesis-patient mismatch (D)</p> Signup and view all the answers

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

<p>To measure gradients across prosthetic valves (A)</p> Signup and view all the answers

Which imaging modality is used to evaluate prosthetic valve thrombosis?

<p>Echocardiography (C)</p> Signup and view all the answers

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

<p>Physiologic regurgitation (A)</p> Signup and view all the answers

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

<p>Transesophageal echocardiography (B)</p> Signup and view all the answers

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

<p>Stenosis (D)</p> Signup and view all the answers

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

<p>Cardiac magnetic resonance imaging (CMR) (C)</p> Signup and view all the answers

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

<p>Paravalvular leak (A)</p> Signup and view all the answers

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

<p>Doppler echocardiography (B)</p> Signup and view all the answers

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

<p>Intervention with either valve repair or valve replacement (A)</p> Signup and view all the answers

Which valves are more frequently repaired?

<p>Mitral and tricuspid valves (A)</p> Signup and view all the answers

Why are diagnostic methods needed in patients with prosthetic valves?

<p>To assess the function of the prosthesis (D)</p> Signup and view all the answers

What is commonly performed in adults especially?

<p>Valve replacement (D)</p> Signup and view all the answers

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

<p>To assess the function of the prosthesis (C)</p> Signup and view all the answers

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

<p>Mechanical valves (D)</p> Signup and view all the answers

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

<p>Tricuspid valve (A)</p> Signup and view all the answers

How is thrombus on bioprosthetic valves described in CT imaging?

<p>Hypoattenuated leaflet thickening (C)</p> 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?

<p>Joint velocity signal analysis (C)</p> Signup and view all the answers

What may thrombus be associated with when seen on echocardiography?

<p>Intracardiac thrombus (A)</p> Signup and view all the answers

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

<p>Endocarditis and CT imaging (A)</p> Signup and view all the answers

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

<p>Severity of regurgitation (A)</p> Signup and view all the answers

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

<p>Prosthesis size (D)</p> Signup and view all the answers

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

<p>Patient-prosthesis size mismatch (B)</p> Signup and view all the answers

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

<p>Increased transvalvular regurgitation (D)</p> Signup and view all the answers

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

<p>Causes stenosis (D)</p> Signup and view all the answers

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

<p>Transthoracic Doppler (C)</p> Signup and view all the answers

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

<p>Reduces valve motion (B)</p> Signup and view all the answers

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

<p>Clinical information (D)</p> Signup and view all the answers

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

<p>Measurements of cardiac chambers and function (D)</p> Signup and view all the answers

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

<p>To assess the presence of PPM (B)</p> Signup and view all the answers

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

<p>It suggests nonstructural valve failure (D)</p> Signup and view all the answers

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

<p>Nonstructural valve failure (A)</p> Signup and view all the answers

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

<p>Nonstructural valve dysfunction (B)</p> Signup and view all the answers

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

<p>Abscess (C)</p> Signup and view all the answers

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

<p>Nonstructural valve dysfunction (D)</p> Signup and view all the answers

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

<p>Nonstructural valve failure (D)</p> Signup and view all the answers

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

<p>Localization of paravalvular regurgitation (D)</p> Signup and view all the answers

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

<p>Absence of PVL (A)</p> Signup and view all the answers

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

<p>Review postoperative imaging (B)</p> Signup and view all the answers

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

<p>Thickening of the aortic root (A)</p> Signup and view all the answers

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

<p>Effective orifice area (C)</p> 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?

<p>Mechanical bileaflet prostheses (B)</p> 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?

<p>DP = 4(V2² - V1²) (B)</p> Signup and view all the answers

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

<p>Pressure recovery (D)</p> Signup and view all the answers

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

<p>Caged-ball valves (C)</p> 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?

<p>Structural valve dysfunction (SVD) (A)</p> Signup and view all the answers

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

<p>Valve calcification (A)</p> Signup and view all the answers

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

<p>In the stent or strut (A)</p> 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?

<p>Nonstructural valve dysfunction (A)</p> Signup and view all the answers

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

<p>Structural valve dysfunction (SVD) (D)</p> Signup and view all the answers

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