Cardiac surgery MCQ (Multiple choice questions)

Q 11. Structures which may be injured in mitral valve replacement are all except

A) Circumflex coronary artery

B) Right coronary artery

C) Aortic valve

D) AV node

Q12.

Answers

11) B

While sewing the valve the sutures are taken accurately in the annulus because there is a risk of injuring

Left circumflex artery at 7-8 o clock

AV node at 1-2 o clock

Aortic valve at 10-12 o clock

notes

Indications of surgery for mitral stenosis

1. Symptomatic patient with mitral valve area less than 1.5 m2

2. Mitral valve area less than 1 m2

3. Embolisation

4. Pulmonary hypertension

5. Increased transvalvular graduent on exercise echocardiography

Mitral insufficiency

Carpentier Classification

Type I annular dilatation

Leaflet perforation

Normal leaflet motion

TypeII. Degenerative diseases

Leaflet prolapse

Ruptured chordae

Increased leaflet motion

Valve has a billowing appearance

TypeIII rheumatic heart diseases

Restricted leaflet motion

Indications of surgery

1. Symptomatic patient

2. Asymptomatic patient with severe mitral insufficiency

3. Decreased ejection fraction

4. Pulmonary hypertension

5. Atrial fibrillation

6. Abnormal stress echo