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CHAPTER 18: THORACIC TRANSPLANTATION

1. What is the typical course of diastolic dysfunction in heart transplant patients?

a. Decline in diastolic dysfunction at 1 year, worse than posttransplant baseline

b. No change in diastolic dysfunction at 1 year compared to posttransplant baseline

c. Improvement in diastolic dysfunction to donor's baseline at 1 year

d. Improvement in diastolic dysfunction at 1 year, but less than donor baseline function

d.

2. A 58-year-old male undergoes orthotropic heart transplantation for nonischemic cardiomyopathy. After weaning from cardiopulmonary bypass, what is the most common abnormality seen on TEE?

a. Tricuspid regurgitation

b. Mitral regurgitation

c. Aortic regurgitation

d. LV regional wall motion abnormalities

a.

3. All of the following are advantages of the bicaval surgical technique over the biatrial technique except:

a. Preserved function of the atria

b. Improved cardiac output

c. Less primary graft failure

d. Less valvular regurgitation

c.

4. Evaluation for a patent foramen ovale (PFO) takes place in the midesophageal bicaval view with agitated saline. A Valsalva maneuver is applied without leftward shift of the interatrial septum, and no bubbles appear in the left atrium after five heart beats. What is the diagnosis?

a. Negative for PFO since no bubbles appeared after five cardiac cycles

b. Inconclusive for PFO, as the LA pressure relative to the RA pressure during the Valsalva is unknown

c. Inconclusive for PFO, as the echocardiographer should allow more cardiac cycles

d. Negative for PFO, since no bubbles appeared with a Valsalva maneuver

b.

5. The following are the most likely explanations for severe right heart dysfunction after orthotopic heart transplant, except:

a. Primary graft failure

b. Recipient preexisting pulmonary hypertension

c. Pulmonary vein thrombosis

d. Pulmonary artery anastomotic stenosis

c.

6. All of the following can give a restrictive pattern on transmitral inflow velocities after heart transplantation except:

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