150861
| Question | Answer |
| What is AS? | Narrowing of the aortic valve orifice |
| As the disease progresses, narrowing is reflected by a____ in valve area;___ jet velocity and ___ pressure gradient | decrease valve area increase jet velocity increase pressure gradient |
| Is AS more common in females and males | Males 2:1 |
| AS is a LV______ overload | pressure |
| what is the etiology of AS | degenerative calcific or senile congenital bicuspid valve rheumatic fever |
| What are the secondary changes that happen with AS | Concentric LVH Post Stenotic dilitation of the Ascending Aorta LAE EF increases Systolic dysfunction |
| When is calcific degenerative As most common? | Age 70-80 Symptoms in SOB, syncope and angina |
| what are some 2D findings of degenerative calcific/senile AS | Increased thickness and stiffness of Ao valve leaflets Initially sclerosis MAC |
| True or false Calcium is echogenic | TRUE |
| true or false It may be difficult to identify bicuspid valve with advanced calcification | TRUE |
| True or false A bicuspid Ao valve will become stenotic earlier and is more vulnerable to calcium infiltration | TRUE |
| What is a normal finding on M-mode with AS | systolic flutter may be hard to measure excursion |
| What is congenital AS | A bicuspid or unicuspid valve |
| When congenital AS when do the symptoms normally appear? | 45-65 years old time to replace valve when symptoms occur |
| What are some 2D findings of Congenital AS | Concentric LVH Football opening Systolic doming, PLAX |
| what is a raphe? | where the cusps are fused together |
| What is an M-mode finding of a bicuspid aortic valve | eccentric leaflet closure (closure line) closure line off of center |
| What is aortic coarctation? | pinching of the descending aorta may be a coexisting lesion abnormality with a bicuspid aortic valve need to use PW Doppler |
| what type of Doppler pattern do you see with aortic coarctation? | Abdominal Aorta run off pattern |
| Where does Rheumatic disease strike first? | Mitral Valve |
| When is Rheumatic AS able to be diagnosed? | Only with the presence of MV involvement |
| True or false Rheumatic AS results in commissural fusion | TRUE |
| Rheumatic AS will have 2D images similar to what disease | calcific disease |
| What formula is used in the cath lab to calculate AVA | Gorlin formula |
| what will a pressure waveform look like with AS | Decreased systolic aortic root pressure Increased LV systolic pressure |
| Which will be higher with AS the peak gradient or the mean gradient? | Peak gradient |
| What measurements correlate well between the cath lab and echo? | mean gradients and AVA |
| true or false Failure to align beam parallel to flow will result in underestimating disease | TRUE |
| Which transducer should be used when performing a Doppler exam on a patient with AS? | PEDOF or Non imaging trx Need to look for highest velocity you can get |
| What will the Doppler signal look like for AS? | smooth veloctiy curve with a dense outer edge, clear peak careful with color, may blur peak velocity |
| How many beats do you average for VTI? | average 3 beats average at least 5 beats for arrhythmias some patients may be 8-10 beats |
| Which views are best for using a non imaging trx | Apical, Suprasternal, R parasternal Record highest velocity window |
| How do you differentiate doppler signals between AS, TR and MR? | Need to look for IVRT duration will be less with AS than with TR and MR |
| true or false With AS acceleration time is longer | TRUE |
| what is the greatest source of error between sonographers? | measuring the LVOT diameter |
| What do you report on a patient with AS | Dertermine how many AV leaftlets Get AS jet velocity Mean gradient AVA by continuity |
| How do you use planimetry for AS | helpful with doppler is unreliable PSAX level of Ao Early systole Trace feature provides AVA in cm2 TEE Correlate AVA |
| Problems with planimetry of the AV | shadowing, reverberations |
| When could you use Aortic Valve Index? | AVA indexed for body size for kids, and small adults AVA index=AVA/BSA |
| Prosthetic Valves are indicated in? | Valvular stenosis Valvular regurgitation Native valve endocarditis Aortic dissection with severe regurg |
| what are the two types of prosthetic valves? | Bioprosthetic and Mechanical |
| What is a heterograft or xenograft? | Animal to human porcine=pig bovine(pericardium)=cow |
| what is an auto-graft? | self to self pulmonary to aorta |
| what is a homograft or allograft? | cadaver |
| Advantages of Bio prosthetic valves | may avoid anticoagularion lower pressure gradients central flow dynamics |
| Disadvantages of Bio Prosthetic valves | Less durable longevity approx 10 years |
| What is another name for the Ball and Cage Valve? | Starr Edwards |
| What is another name for the Tilting disc valve? | Bjork Shiley |
| what is another name for the bi leaflet valve | St. Jude 3 flow channels least stenotic |
| what are some complications of mechanical valves? | thrombus, stenosis, dehiscence,infective endocarditis, hemolysis, mechanical failure, pannus |
| what is dehiscence? | separation from the suture line |
| what is pannus? | endotheleal overgrowth, tissue grows over metal and can cause stenosis and regurg |
| What will be listed on a patient identification card? | type postion size (mm) Peak Gradient Mean Gradient EOA(valve area) velocity |
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