Mitral Stenosis

What are the consequences of mitral stenosis on rhythm issues.

AFIB due to left atrial distention and incomplete emptying of left atrium.

Where is a balloon mitral valvutomy preformed

Cathlab

What is the cannulation technique for a mitral valve replacement via mini-thorocotomy trans-septal approach

Femoral arterial, femoral vein with multiport venous cannula into SVC

Congenital mitral stenosis is associated with

Hypoplastic left ventricle and hypoplastic Aorta

What effect does mitral stenosis have on plasma volume

Increased plasma volume but low protein concentration

How does to body compensate for mitral stenosis?

Increases SVR (SVR increases to maintain systemic pressure.) Slowing of Heart rate:increases the duration of diastole which increase ventricular filling

What effects does mitral stenosis have on the brain?

Infarction in patients with embolic episodes. TIA, hemiplegia

What are the categories of MS

Mild MS: 1.5-2.5 cm2 Moderate MS: 1.0-1.5 cm2 Severe MS: < 1.0 cm2 Critical MS: ≤ 0.7 cm2

what is mitral annular calcification

Progressive calcium deposits along and beneath mitral valve annulus. Associated w/ atherosclerosis. The mitral leaflet commisures and and anterior leaflet distinguishes MAC from Rheumatic heart disease

Congestive hepatopathy can cause abnormalities in the clotting cascade due to?

Prolonged PT/INR due to impaired synthesis of factors II, V, VII, X

Rheumatic fever is generally caused by

Streptococcus bacterial infection

What effect does mitral stenosis have on hemoglobin

decreased hematocrit

Mitral stenosis causes an increase in SVR, what does this do to systemic perfusion?

high diastolic BP, cold limbs, lower limbs veins are constricted

Do patients with hepatomegaly have hyperbilirubinemia or hypobilirubinemia

hyperbilirubinemia

What is bacterial endocarditis

infection of inner lining of heart, may affect the valves

How does rheumatic heart disease cause heart failure

severely narrowed or leaky heart valve

What happens to body volume from mitral stenosis

↑pulmonary volume, ↑systemic volume, ↑CVP, liver enlargement, effusions, development of PHTN

Stenotic Mitral Valve obstructs the flow of blood from Left Atrium to Left Ventricle resulting in ...

1) Back Pressure Effect: results in accumulation of blood in the pulmonary circulation, RA, SVC/IVC, and liver 2) Decreased forward flow: Reduced LV filling leads to reduced forward flow, ie, reduced cardiac output

AT what mitral valve area is it considered severe

< 1.0 cm2

What is the typical cannulation for mitral valve replacement with a paraseptal approach?

Aortic, bi-caval venous

Significant MS is almost always due to

Rheumatic heart disease

What effect does mitral stenosis have on the liver

chronic passive congestion, ↑bilirubin, ↑SGPT (serum glutamic-pyruvic transaminase) or ALT (Alanine transaminase).