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).