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technique of operation tee probe is passed in all cases soon after anaesthesia the initial steps and exposure of mitral valve are done as for
mitral valve repair whenever possible the valve has to be repaired rather than replaced preoperative investigations and a tee done on the
asymptomatic patient the current opinion is that in asymptomatic patients with left ventricular dysfunction and severe mr surgery should not be
when a ventricqlar septa1 defect vsd is present with no aortic stenosis the peak velocitgr across the defect reflects the difference in pressure
symptomatic patient symptomatic patient class 11 111 or iv with severe mr and normal left ventricular function ef gt 06 and end systolic dimension of
chronic mitral regurgitation in chronic mitral regurgitation the asymptomatic phase is much longer than in mitral stenosis onset of symptoms may
pressure calculation made using the bernoulli equation may be used in conjunction with pressure measurements made by other modalities to
though it has bees suggested that doppler echocardiography may be useful for non-invasive determinations of stroke volume and cardiac output
acute mitral regurgitation acute mitral regurgitation is an indication for early surgery if patient is haemodynamically unstable pre-operative
the simplified bernoulli equation may be applied to peak velocity measurements to make non-invasive estimates of pressure gradients where vl
chronic mitral regurgitationchronic mitral regurgitation may have different aetiological factors1 rheumatic2 degenerative-myxomatous malformation3
acute mitral regurgitation this may be caused by chordal rupture infective endocarditis or acute myocardial infarction in acute myocardial
results of mitral valve replacement the risk of mitral valve replacement is reported as 3-5 per cent it also depends on multiple factors like age
chordal sparing operation for sparing both leaflets an incision is made on the anterior leaflet close to the annulus and then extended centrally and
classic procedure the approach is the same as described earlier for open mitral valvotomy the excision starts with an anterior incision on the
mitral valve replacement when mitral valve replacement for a calcified stenotic valve is done usually it is a classical procedure removing
open mitral valvotomy technique a median stemotomy is done peri cardium opened and stay sutures taken after heparinisation ascending aorta is
there are two types of doppler examination1 pulse wave doppler2 continuous wave dopplerboth these modalities are necessary part of doppler
direction of flow--either towards or away from the transducer positive or negative doppler shiftstiming-instantaneous velocity and direction of flow
doppler echocardiogaphy is based on the doppler effect which was described by the austrian phyicist christian doppler in 1842 the
doppler echocardiojgraphy measures blood flow velocities and direction of blood flow in the heart add great vessels the characteristics
these views are obtained by placing the transducer in the suprasternal notch with the ridge pointing cephalad the neck is extended during the
in addition to parasternal and apical transducer position subcostal view also provides imaging window in adult patients the patient is supine with
techniques operation is done under general endo tracheal anaesthesia patient is positioned with the left chest tilted up using a sand bag under left
the transducer is placed in the mid axillary line with the transducer ridge pointing towards the patients left to obtain the four-chamber view