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CHAPTER 17: ASSESSMENT OF MECHANICAL CIRCULATORY SUPPORT DEVICES
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1. The most probable mechanism implicated in the development of significant AI after institution of full LVAD support is:
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a. Presence of endocarditis
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c. Exposure of closed valve to continuous systolic rather than diastolic pressure
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d. Aortic leaflet perforation
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e. Aortic leaflet prolapse
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c. Exposure of a closed valve to continuous systolic rather than diastolic pressure. Under normal conditions, a closed native aortic valve is exposed to intermittent aortic diastolic pressure instead of continuous systolic pressure.
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2. Which factors are associated with possible worsening in TR severity after LVAD implantation?
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a. Increased preload to the RV due to an increased in left-sided cardiac output
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b. Post-CPB increase in pulmonary vascular resistance
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c. Increase in PA pressure and RV dysfunction due the systemic inflammatory response
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d. Leftward shift of the interventricular septum caused by LV unloading
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3. What is the average peak filling velocity in the inflow cannula of an axial flow device?
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4. In order to perform TEE assessment for air entrapment in an LVAD pump after implantation, which echocardiographic window is the most useful?
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d. ME RV inflow-outflow view
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c. ME AV LAX view. The ME AV LAX view will allow visualization of the left-sided chambers, the LVOT, the ascending aorta, and the outflow cannula. All those are places where air bubbles will collect both downstream and upstream from the LVAD pump.
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5. When performing evaluation for presence of patent foramen ovale with intracardiac shunt, the reversal of the left-to-right atrial pressure gradient should be captured by agitated saline contrast study by imaging at the following time:
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a. Before application of the Valsalva maneuver
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b. During the Valsalva maneuver and before injection of agitated ...