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Transcatheter aortic valve replacement

doi: 10.1097/
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INSTRUCTIONS Transcatheter aortic valve replacement


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Lippincott Professional Development will award 1.5 contact hours for this continuing nursing education activity. Lippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.5 contact hours, and the District of Columbia, Georgia, and Florida CE Broker #50-1223.

Payment: The registration fee for this test is $17.95.

Transcatheter aortic valve replacement

GENERAL PURPOSE: To provide an overview of TAVR. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. List the clinical manifestations of aortic stenosis. 2. Identify situations in which TAVR may be preferred over SAVR. 3. Summarize the TAVR procedure.

  1. The symptom triad of aortic stenosis consists of syncope, heart failure, and
    1. hypertension.
    2. angina.
    3. dysrhythmias.
  2. The gold standard diagnostic study for aortic stenosis is
    1. coronary arteriography.
    2. electrocardiography.
    3. echocardiography.
  3. One finding definitive of severe aortic stenosis is
    1. aortic valve area of 1.0 cm2 or less.
    2. mean transvalvular pressure gradient of 30 mm Hg or more.
    3. maximum aortic jet velocity greater than 3.0 m/s.
  4. Intervention for aortic stenosis typically occurs as patients approach what stage?
    1. progressive
    2. moderate
    3. asymptomatic severe
  5. A candidate is considered a high surgical risk if he or she has
    1. a PROM score of 6% or greater.
    2. a frailty index of two or greater.
    3. four compromised organ systems that will not improve postoperatively.
  6. Absolute contraindications to SAVR include
    1. severe liver disease.
    2. severe right ventricular dysfunction.
    3. a highly calcified aorta.
  7. Factors that favor SAVR over TAVR include
    1. a calcified bicuspid valve.
    2. patient age over 75.
    3. poor left ventricular function.
  8. What diagnostic study is completed pre-TAVR to determine the severity of aortic stenosis, determine if there is concomitant valvular heart disease, and evaluate valve anatomy and valve hemodynamics?
    1. TEE
    2. coronary angiography
    3. computed tomography
  9. Fitting the patient for the most appropriately sized valve is accomplished via
    1. ultrasonography.
    2. computed tomography angiography.
    3. MRI.
  10. During TAVR, balloon valvuloplasty and valve expansion are done with
    1. transient cardiac standstill.
    2. normal circulation.
    3. rapid ventricular pacing.
  11. The most common complication seen after TAVR is
    1. stroke.
    2. vascular perforation.
    3. high-degree AV block.
  12. The delayed period phase for potential stroke following TAVR is defined as postoperative
    1. hours 24 through 48.
    2. days 2 through 30.
    3. day 30 through 1 year postprocedure.
  13. Predictors for AKI in patients undergoing TAVR include
    1. low ejection fraction.
    2. younger age.
    3. male gender.
  14. A meta-analysis evaluating outcomes in low- and intermediate-risk patients determined that, compared with SAVR, the transfemoral TAVR approach was associated with decreased incidence of
    1. stroke.
    2. permanent pacemaker implantation.
    3. aortic valve reintervention.
  15. The Mid-Atlantic Permanente Medical Group TAVR program shortened the average patient's length of stay to
    1. 1.0 day.
    2. 1.9 days.
    3. 3.2 days.
  16. Prior to discharge following TAVR, the patient should begin a medication regimen including lifelong daily aspirin with 6 months of
    1. warfarin.
    2. rivaroxaban.
    3. clopidogrel.
  17. For the first 4 weeks after TAVR, the patient should avoid
    1. lifting more than 10 lbs.
    2. taking a bath.
    3. showering.
  18. A 5-meter walk test will be performed at which follow-up visit?
    1. 30 days
    2. 6 weeks
    3. 1 year
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