CCI ECHO ACTUAL EXAMS TEST PAPER QUESTIONS AND
ANSWERS SURE A+
of murmur associated with Aortic Insufficiency - ✔✔Austin Flint. Aortic Insufficiency is
back flow into LVOT/Left Ventricle. Blood mingles with normal Mitral Valve flow
✔✔An Aortic Insufficiency pressure half time of <_____ is severe - ✔✔Aortic
Insufficiency or Aortic reurgitation<200 (>500, mild)
✔✔What is a common arrhythmia associated with mitral valve prolapse? -
✔✔Paroxysmal Supraventricular tachycardia. It is believed this may be due to the stress
and anxiety of feeling chest pain, etc. This in turn provokes SVT
✔✔A systolic murmur heard best at the apex of the heart is most likely what? - ✔✔Mitral
regurgitation
✔✔The D to E on a Mitral valve M mode represents what? - ✔✔Opening of the Mitral
Valve or the Rapid filling phase
✔✔A ratio used to calculate the severity of a shunt - ✔✔Qp/Qs--- Depending on the
location of the shunt a SV is determined for pulmonary blood flow vs. systemic blood
flow
✔✔An associated finding of Interatrial septal aneurysm is an - ✔✔ASD. An Interatrial
septal aneurysm is bulging of the fossa ovalis region of the interatrial septum. Septal
aneurysms have a high likelihood of fenestration (up to 90%)
✔✔The Star Edwards prosthetic valves are located in both the mitral and aortic
positions; Mitral Regurgitation is best detected from which window? - ✔✔Subcostal
✔✔**VALVES**Which is the proper term when the pulmonic valve is removed and put
in place of the aortic valve in the same patient? - ✔✔Autograft
✔✔What is a Heterograph/Xenograph? - ✔✔bioprosthetic valve transferred from animal
to human
✔✔Bioprosthetic valves are also known as? - ✔✔1. Heterograph
2. Xenograph
✔✔2 types of bioprosthetic valves? - ✔✔1. Porcine
2. Bovine
✔✔What is a porcine bio valve? - ✔✔a pig's aortic valve placed on stents, attached to a
sewing ring and glutaraldehyde stabilized.
,✔✔What are the most common brands of Porcine bio valves? - ✔✔1. Hancock
2. Carpentier-Edwards
3. Intact
✔✔What are the most common brands of bovine pericardium? - ✔✔1. Carpentier-
Edwards
2. Ionescu-Shiley (withdrawn from the US market)
3. Mitroflow
✔✔Types of mechanical valves? - ✔✔1. Caged disc (Beall most common; no longer
available)
2. Tilting disc (Bjork-Shiley, Medtronic-Hall are most common)
3. Bileaflet (St. Judes; most frequently used).
✔✔Brand of caged disc mechanical valve? - ✔✔Beall is the most common; no longer
available
✔✔Most common type of single tilting disc mechanical valves? - ✔✔Medtronic-Hall
✔✔All of the following are tissue valves except?
a.. Hancock
b. Carpentier-Edwards
c. Bjork-Shiley
d. Ionescu-Shiley - ✔✔c. Bjork-Shiley
✔✔Which of the following is a bileaflet tilting disc valve?
a. Carpentier-Edwards
b. Bjork-Shiley
c. Medtronic-Hall
d. St. Jude's - ✔✔d. St Jude's
is the most common prosthetic valve
✔✔Ball and cage mechanical valves are made by? - ✔✔Starr-Edwards
✔✔Definition of Pannus? - ✔✔tissue overgrowth
✔✔Complications with prosthetic heart valves? - ✔✔1. dehiscience
2. Pannnus
✔✔Advantage of bio valves? - ✔✔no anticoagulation therapy needed
Advantage of mechanical valves?
durability
,✔✔2 most common tissue valve companies? - ✔✔1. Carpentier-Edwards
2. Hancock
✔✔Most frequently used mechanical valve? - ✔✔Bileaflet by St. Jude's (aka tilting disc)
✔✔Types of Porcine tissue valves? - ✔✔1. Hancock
2. Intact
3. Carpentier-Edwards
✔✔What is the most common cause of a bioprosthetic valve dysfunction? - ✔✔tissue
degeneration
✔✔On 2 D what are the differences between mechanical and bioprosthetic valves
From the patient standpoint what are the differences between these valves? - ✔✔Bio
prosthetics = 2D Some masking is present because the central area of these bells is
fabricated and it biologic material, fewer reverberations
Disadvantage lifelong anticoagulants, higher transvaluation gradient than other
prosthetic valves
Mechanical = 2D more masking is present, more reverberations. For the patient
mechanical is more durable up to 20 years, but necessitates lifelong anticoagulants
For the patient bioprosthetic are less durable 10 to 12 years, they do not require
anticoagulation
✔✔What is a commonly used cage ball prosthetic valve, and
What are its advantages and disadvantages? - ✔✔Star Edwards.
Advantage is durability, last 15 to 20 years.
Disadvantage lifelong anticoagulants, higher transvaluation gradient than other
prosthetic valves
✔✔Name a caged disc prosthetic valve.
What are the advantages and disadvantages of these valves? - ✔✔Beall Valve.
These valves have a lower profile (height) then the starr Edwards, but are no longer
used.
Main advantage= durability and low-profile.
Disadvantage= high transboundary gradient and more hemolysis than other prosthetic
valves.
✔✔What is a commonly used tilting disc prosthetic valve?
What are the advantages and disadvantages of this type of valve?
What are the advantages and disadvantages of this type of valve? - ✔✔Bork-Shiley.
Better flow dynamics than valves have central occluder.
, Advantage good flow dynamics, low transvaluation gradient, decreased turbulence.
Disadvantage questionable durability and more regurgitation than other valves
✔✔How is a porcine prosthetic valve made?
What are the advantages and disadvantages of these valves? - ✔✔The valve is
preserved in glutaraldehyde and then attached to polypropylene stent, which has a
dacron sewing ring. Because the preserve leaflets are nonviable, valve rejection is not a
problem.
Advantage low thrombogenicity. Does not need anticoagulation. Low transvalvular
gradients.
Disadvantage less durability and longevity the mechanical valves. 5 to 10 years.
Porcine leaflets become thickened and stenosed
✔✔For caged ball (Starr-Edwards)
Where should transducee be placed for MV or AOV? - ✔✔MV = Left ventricular apex,
so that the full excursion of the leaflets can be documented as a ball moves into the
open position. This view also allows evaluation of the balls timing.
AOV= Transducer should be placed above the valve, either in the suprasternal or right
supraclavicular window. Placement allow the balls excursion, and timing to be
documented
✔✔What are Five complications of prosthetic valve dysfunction? - ✔✔Perivalvular
leakage, bioprosthetic stenosis/degeneration, valve dehiscence/strut failure, ring
abscess, thrombus formation, endocarditis, hemolysis
✔✔What is the most common type primary ( benign) pediatric cardiac tumor? -
✔✔Rhabdomyoma, beniegn usually multiple assoc w/ tuberous sclerosis, usually
multiple and small but can be single and large. Most common in the right ventricle
✔✔*TUMORS**The most common benign tumor on the aortic valve is: - ✔✔Papillary
fibroelastoma
- 3rd most common benign cardiac tumor
- presents on valves (Ao and MV) most common
✔✔The most common cardiac valvular tumors are what - ✔✔Fibroelastoma
✔✔Types of primary benign (intracardiac) tumors? - ✔✔1. Myxoma (most common
benign tumor found in adults; 30%)
2. Papilloma (10%)
3. Lipoma (10%)
4. Fibroma (4%)
ANSWERS SURE A+
of murmur associated with Aortic Insufficiency - ✔✔Austin Flint. Aortic Insufficiency is
back flow into LVOT/Left Ventricle. Blood mingles with normal Mitral Valve flow
✔✔An Aortic Insufficiency pressure half time of <_____ is severe - ✔✔Aortic
Insufficiency or Aortic reurgitation<200 (>500, mild)
✔✔What is a common arrhythmia associated with mitral valve prolapse? -
✔✔Paroxysmal Supraventricular tachycardia. It is believed this may be due to the stress
and anxiety of feeling chest pain, etc. This in turn provokes SVT
✔✔A systolic murmur heard best at the apex of the heart is most likely what? - ✔✔Mitral
regurgitation
✔✔The D to E on a Mitral valve M mode represents what? - ✔✔Opening of the Mitral
Valve or the Rapid filling phase
✔✔A ratio used to calculate the severity of a shunt - ✔✔Qp/Qs--- Depending on the
location of the shunt a SV is determined for pulmonary blood flow vs. systemic blood
flow
✔✔An associated finding of Interatrial septal aneurysm is an - ✔✔ASD. An Interatrial
septal aneurysm is bulging of the fossa ovalis region of the interatrial septum. Septal
aneurysms have a high likelihood of fenestration (up to 90%)
✔✔The Star Edwards prosthetic valves are located in both the mitral and aortic
positions; Mitral Regurgitation is best detected from which window? - ✔✔Subcostal
✔✔**VALVES**Which is the proper term when the pulmonic valve is removed and put
in place of the aortic valve in the same patient? - ✔✔Autograft
✔✔What is a Heterograph/Xenograph? - ✔✔bioprosthetic valve transferred from animal
to human
✔✔Bioprosthetic valves are also known as? - ✔✔1. Heterograph
2. Xenograph
✔✔2 types of bioprosthetic valves? - ✔✔1. Porcine
2. Bovine
✔✔What is a porcine bio valve? - ✔✔a pig's aortic valve placed on stents, attached to a
sewing ring and glutaraldehyde stabilized.
,✔✔What are the most common brands of Porcine bio valves? - ✔✔1. Hancock
2. Carpentier-Edwards
3. Intact
✔✔What are the most common brands of bovine pericardium? - ✔✔1. Carpentier-
Edwards
2. Ionescu-Shiley (withdrawn from the US market)
3. Mitroflow
✔✔Types of mechanical valves? - ✔✔1. Caged disc (Beall most common; no longer
available)
2. Tilting disc (Bjork-Shiley, Medtronic-Hall are most common)
3. Bileaflet (St. Judes; most frequently used).
✔✔Brand of caged disc mechanical valve? - ✔✔Beall is the most common; no longer
available
✔✔Most common type of single tilting disc mechanical valves? - ✔✔Medtronic-Hall
✔✔All of the following are tissue valves except?
a.. Hancock
b. Carpentier-Edwards
c. Bjork-Shiley
d. Ionescu-Shiley - ✔✔c. Bjork-Shiley
✔✔Which of the following is a bileaflet tilting disc valve?
a. Carpentier-Edwards
b. Bjork-Shiley
c. Medtronic-Hall
d. St. Jude's - ✔✔d. St Jude's
is the most common prosthetic valve
✔✔Ball and cage mechanical valves are made by? - ✔✔Starr-Edwards
✔✔Definition of Pannus? - ✔✔tissue overgrowth
✔✔Complications with prosthetic heart valves? - ✔✔1. dehiscience
2. Pannnus
✔✔Advantage of bio valves? - ✔✔no anticoagulation therapy needed
Advantage of mechanical valves?
durability
,✔✔2 most common tissue valve companies? - ✔✔1. Carpentier-Edwards
2. Hancock
✔✔Most frequently used mechanical valve? - ✔✔Bileaflet by St. Jude's (aka tilting disc)
✔✔Types of Porcine tissue valves? - ✔✔1. Hancock
2. Intact
3. Carpentier-Edwards
✔✔What is the most common cause of a bioprosthetic valve dysfunction? - ✔✔tissue
degeneration
✔✔On 2 D what are the differences between mechanical and bioprosthetic valves
From the patient standpoint what are the differences between these valves? - ✔✔Bio
prosthetics = 2D Some masking is present because the central area of these bells is
fabricated and it biologic material, fewer reverberations
Disadvantage lifelong anticoagulants, higher transvaluation gradient than other
prosthetic valves
Mechanical = 2D more masking is present, more reverberations. For the patient
mechanical is more durable up to 20 years, but necessitates lifelong anticoagulants
For the patient bioprosthetic are less durable 10 to 12 years, they do not require
anticoagulation
✔✔What is a commonly used cage ball prosthetic valve, and
What are its advantages and disadvantages? - ✔✔Star Edwards.
Advantage is durability, last 15 to 20 years.
Disadvantage lifelong anticoagulants, higher transvaluation gradient than other
prosthetic valves
✔✔Name a caged disc prosthetic valve.
What are the advantages and disadvantages of these valves? - ✔✔Beall Valve.
These valves have a lower profile (height) then the starr Edwards, but are no longer
used.
Main advantage= durability and low-profile.
Disadvantage= high transboundary gradient and more hemolysis than other prosthetic
valves.
✔✔What is a commonly used tilting disc prosthetic valve?
What are the advantages and disadvantages of this type of valve?
What are the advantages and disadvantages of this type of valve? - ✔✔Bork-Shiley.
Better flow dynamics than valves have central occluder.
, Advantage good flow dynamics, low transvaluation gradient, decreased turbulence.
Disadvantage questionable durability and more regurgitation than other valves
✔✔How is a porcine prosthetic valve made?
What are the advantages and disadvantages of these valves? - ✔✔The valve is
preserved in glutaraldehyde and then attached to polypropylene stent, which has a
dacron sewing ring. Because the preserve leaflets are nonviable, valve rejection is not a
problem.
Advantage low thrombogenicity. Does not need anticoagulation. Low transvalvular
gradients.
Disadvantage less durability and longevity the mechanical valves. 5 to 10 years.
Porcine leaflets become thickened and stenosed
✔✔For caged ball (Starr-Edwards)
Where should transducee be placed for MV or AOV? - ✔✔MV = Left ventricular apex,
so that the full excursion of the leaflets can be documented as a ball moves into the
open position. This view also allows evaluation of the balls timing.
AOV= Transducer should be placed above the valve, either in the suprasternal or right
supraclavicular window. Placement allow the balls excursion, and timing to be
documented
✔✔What are Five complications of prosthetic valve dysfunction? - ✔✔Perivalvular
leakage, bioprosthetic stenosis/degeneration, valve dehiscence/strut failure, ring
abscess, thrombus formation, endocarditis, hemolysis
✔✔What is the most common type primary ( benign) pediatric cardiac tumor? -
✔✔Rhabdomyoma, beniegn usually multiple assoc w/ tuberous sclerosis, usually
multiple and small but can be single and large. Most common in the right ventricle
✔✔*TUMORS**The most common benign tumor on the aortic valve is: - ✔✔Papillary
fibroelastoma
- 3rd most common benign cardiac tumor
- presents on valves (Ao and MV) most common
✔✔The most common cardiac valvular tumors are what - ✔✔Fibroelastoma
✔✔Types of primary benign (intracardiac) tumors? - ✔✔1. Myxoma (most common
benign tumor found in adults; 30%)
2. Papilloma (10%)
3. Lipoma (10%)
4. Fibroma (4%)
