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CPD Questions (Transthoracic Echo after Mitral TEER)
Name:
First Name:
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I confirm that I have watched the accompanying video in full before completing these CPD questions and claiming CPD points.:
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1. Before performing a transthoracic echocardiogram following Mitral Transcatheter Edge-to-Edge Repair (TEER), what is the first question the sonographer should ask?:
A. What was the patient's blood pressure?
B. What anti-coagulation was prescribed?
C. What procedure was performed?
D. How many echocardiograms has the patient previously had?
E. Was the patient fasting?
2. What is the preferred mean transmitral pressure gradient following Mitral TEER?:
A. Less than 2 mmHg
B. Less than 3 mmHg
C. Less than 5 mmHg
D. Less than 8 mmHg
E. Less than 10 mmHg
3. Following successful TEER for severe mitral regurgitation, what commonly happens to left ventricular systolic function?:
A. It always improves immediately.
B. It frequently appears reduced because the true LV systolic function has been unmasked.
C. It remains unchanged in all patients.
D. It becomes hyperdynamic.
E. It cannot be assessed after TEER.
4. Which major complication is characterized by a hypermobile device attached to only one mitral leaflet?:
A. Device thrombosis
B. Device embolization
C. Single leaflet device detachment (SLD)
D. Prosthetic valve stenosis
E. Mitral annular calcification
5. Which complication may require urgent surgical removal because the device has migrated into the left ventricle?:
A. Device fracture
B. Device embolization
C. Infective endocarditis
D. Pericardial effusion
E. Valve thrombosis
6. What is the major imaging artifact encountered following Mitral TEER?:
A. Reverberation from the left atrium
B. Near-field clutter
C. Posterior acoustic shadowing from the device
D. Mirror-image artifact
E. Side-lobe artifact
7. Why is careful transseptal puncture positioning important during Mitral TEER?:
A. It reduces the risk of damaging the coronary arteries.
B. It minimizes the risk of puncturing the aortic valve.
C. It helps avoid entering Waterston's groove and causing cardiac tamponade.
D. It improves left ventricular systolic function.
E. It prevents device embolization.
8. Why is extensive panning and imaging from multiple windows particularly important after Mitral TEER?:
A. To improve left ventricular volume measurements.
B. To identify multiple residual mitral regurgitation jets that may occur in unusual directions.
C. To eliminate Doppler aliasing.
D. To measure pulmonary artery pressure more accurately.
E. To reduce acoustic shadowing.
9. Why can right ventricular function improve shortly after successful Mitral TEER?:
A. The device directly enhances RV contractility.
B. The procedure reduces pulmonary pressures by relieving mitral regurgitation.
C. The clip stimulates right ventricular myocardium.
D. Right ventricular preload is eliminated.
E. The tricuspid valve becomes more competent immediately.
10. Which finding should raise the greatest concern for clinically significant recurrent mitral regurgitation following TEER?:
A. A stable device with a trivial medial jet
B. Mean transmitral gradient below 5 mmHg
C. A hypermobile device
D. Mild reduction in left ventricular ejection fraction
E. Mild posterior acoustic shadowing
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