Echocardiography during Interventional Procedures

Echocardiography during Interventional Procedures
Echocardiography during Interventional Procedures
1. Which of the following is not a contraindication for
percutaneous mitral balloon valvuloplasty (PMBV) in
rheumatic mitral stenosis?
A. Thrombus in the left atrial appendage
B. Lutembacher syndrome
C. Thrombus in the body of the left atrium
D. Mitral valve score of 14
E. Moderate mitral regurgitation
2. Figure 50.1 and Video 50.1 demonstrating the right atrial
aspect of an atrial septal defect (ASD) were obtained
from a 72-year-old female during evaluation for possible
percutaneous closure. The dotted yellow line represents the
largest ASD diameter (30 mm), while the solid yellow line
represents the ASD’s aortic rim (7 mm). Other ASD rims
were also measured and deemed sufŠcient for ASD closure.
Additionally, echocardiography demonstrated an enlarged
right heart and no signiŠcant pulmonary arterial hypertension.
Which of the following is the correct answer?
A. ASD is too large for device closure.
B. ASD anatomy is favorable for device closure.
C. The patient is too old for device closure.
D. The aortic rim of ASD is too small for device closure.
E. The patient does not have a secundum ASD.
3. Figure 50.2 and Video 50.2 were obtained from a 23-yearold male with an atrial septal defect (ASD) referred for
possible percutaneous closure.
Panel A demonstrates the left atrial aspect of an ASD (asterisk); its diameters were measured at 18 × 12 mm.
Panel B and Video 50.2 demonstrate the left ventricular side
of the patient’s mitral valve.
Chapter 50
Echocardiography during
Interventional Procedures
Muhamed Saric and Itzhak Kronzon
Figure 50.1
Figure 50.2
(c) 2015 Wolters Kluwer. All Rights Reserved.
Chapter 50 Echocardiography during Interventional Procedures 429
Echocardiography also demonstrated moderate mitral regurgitation, enlarged right heart, no pulmonic stenosis, and a
Echocardiography during Interventional Procedures
peak systolic gradient of the tricuspid regurgitant jet of
25 mm Hg. Right atrial pressure was estimated at 3 mm Hg.
You recommend cancelation of percutaneous ASD closure in
this patient because:
A. ASD is too small.
B. The patient has pulmonary hypertension.
C. The secundum ASD is not amenable to percutaneous
D. The right heart is dilated.
E. There is mitral valve pathology.
4. Figure 50.3 was obtained by 3D transesophageal echocardiography and demonstrates the left atrial aspect of the mitral
valve in the so-called surgical view.
What structure is marked by the arrow?
A. Left atrial appendage
B. Atrial septal defect
C. Right pulmonary artery
D. Aortic root
E. Left upper pulmonary vein
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